Jae Sung Park, D.M.D. Valid NPI

Individual provider · General Practice Dentistry · Rock Hill, SC

NPI

1134551716

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

DGD.8288 GD (SC)

Sex

Male

Sole proprietor

No

Enumerated

2013-08-06

Last updated

2020-12-24