| Park Dentistry Llc | |
|
1947 S 60th St West Allis WI 53219-1552 | |
| (414) 545-6747 | |
| (414) 545-2488 |
| Full Name | Park Dentistry Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1947 S 60th St, West Allis, Wisconsin |
| Authorized Official Name and Position | Joon Jae Park (OWNER) |
| Authorized Official Contact | 4145456747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Dentistry Llc 1947 S 60th St West Allis WI 53219-1552 Ph: (414) 545-6747 | Park Dentistry Llc 1947 S 60th St West Allis WI 53219-1552 Ph: (414) 545-6747 |
| NPI Number | 1902566003 |
|---|---|
| Provider Enumeration Date | 12/30/2021 |
| Last Update Date | 12/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902566003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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