Jintae Park DDS

NPI 1629110747 - Dentist - 122300000X

NPI Details
NPI 1629110747
Gender Male
Enumeration Date 02/13/2007
Last Updated 01/09/2010
Entity Type Individual
Active Over 9 years ago
Practice Location
6795 S VIRGINIA ST
E
RENO NV, 89511-1171, US
Phone (775) 853-0503
Fax (775) 853-0504
Business Location
815 KILEY RANCH PKWY
2901
SPARKS NV, 89436-4066, US
Phone (626) 434-6150
Fax (775) 657-8619
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 54686
Remove 1629110747 NPI Number
 

According to our database, Dr. Jintae Park DDS NPI is 1629110747, taxonomy code is 122300000X and license number is 54686, license state is located at California. Jintae Park DDS physically located at 6795 S Virginia St, Reno NV, 89511-1171. NPI Number Jintae Park DDS has the Individual type.

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1629110747 NPI number is provided on an as is basis without warranty of any kind. 1629110747 is maintained by the National Plan & Provider Enumeration System. The contents of Jintae Park DDS are for informational purposes only.