Ji Park, DDS

NPI #1174913073 in Flushing, New York

Provider Information

NPI Number: 1174913073
Entity Type: Individual
Name: Ji Park, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Jan 29, 2015
Last Updated: Jan 10, 2018

Practice Location

Address: 4500 PARSONS BLVD
City: Flushing
State: New York
ZIP Code: 11355-2205
Phone: (718) 670-5521

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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