Provider Demographics
NPI:1285887810
Name:PARK, WOOIL STEVEN (DDS)
Entity type:Individual
Prefix:DR
First Name:WOOIL
Middle Name:STEVEN
Last Name:PARK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 ROUTE 17
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2574
Mailing Address - Country:US
Mailing Address - Phone:201-549-8811
Mailing Address - Fax:201-549-8840
Practice Address - Street 1:201 ROUTE 17
Practice Address - Street 2:11TH FLOOR
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2574
Practice Address - Country:US
Practice Address - Phone:201-549-8811
Practice Address - Fax:201-549-8840
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222351223P0700X
NJ22DI023247001223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics