DR. Brian Park, DDS

NPI #1689842379 in Southampton, New York

Provider Information

NPI Number: 1689842379
Entity Type: Individual
Name: DR. Brian Park, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Feb 14, 2008
Last Updated: Jun 3, 2009

Practice Location

Address: 325 MEETING HOUSE LN
Address 2: BLDG #2 SUITE 401
City: Southampton
State: New York
ZIP Code: 11968-5087
Phone: (631) 283-0352

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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