Park, Dong Jin

Park, Dong Jin is an individual health care provider with primary practice located at 490 S Broad St , Meriden CT 06450. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Park, Dong Jin can be contacted via phone (203) 237-1000.

Contact Information

Primary practice address
490 S Broad St Meriden CT 06450
Phone: (203) 237-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 010794 Connecticut
Dental Providers / General Practice 1223G0001X 010794 Connecticut

Profile Details

NPI number 1174888622
LBN Legal business name Park, Dong Jin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2012
Last updated Sep 26th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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