John J Park LLC

NPI #1992584288 in Portland, Oregon

Provider Information

NPI Number: 1992584288
Entity Type: Organization
Organization Name: John J Park LLC
Subpart: Yes (part of a larger organization)
Parent Organization: JOHN J PARK LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 26, 2023
Last Updated: Sep 26, 2023

Practice Location

Address: 2100 NE BROADWAY ST
City: Portland
State: Oregon
ZIP Code: 97232
Phone: (503) 284-2893

Authorized Official

Name: JOHN JOONTAE PARK, DDS
Title: DENTIST, OWNER
Phone: (503) 348-3207

Specialties & Taxonomy Codes

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

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