James Park D.M.D
Clinic/Center, Dental in Southbridge, MA. Organization (NPI-2).
NPI number1669964839
StatusActive
Last updated in NPPESJun 4, 2018
Details
- NPI
- 1669964839
- Entity type
- Organization (NPI-2)
- Legal business name
- James Park D.M.D
- Organization subpart
- No
- Enumeration date
- Jun 4, 2018
- Last updated
- Jun 4, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | DN1856630 | MA | Yes |
Other names
- James Park D.M.D (Former Legal Business Name)
Practice location
44 Everett StSouthbridge, MA 01550-2620
Phone 508-764-4600 · Fax 508-765-5862
Mailing address
44 Everett StSouthbridge, MA 01550-2620
Phone 508-764-4600 · Fax 508-765-5862
Authorized official
James Park
Dentist
5087644600
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