National Provider Identifier
Ellen Park, D.D.S.
Ellen Park, D.D.S. is listed in the NPPES registry with a primary specialty of Student In An Organized Health Care Education/Training Program in Rochester, NY and a listed phone number of (585) 275-5087.
Profile Overview
- NPI
- 1619075413
- Provider Type
- Individual
- Primary Specialty
- Student In An Organized Health Care Education/Training Program
- Enumeration Date
- September 20, 2006
- Last Updated
- July 08, 2007
Practice Location
- 625 Elmwood Ave
- Box 683
- Rochester, NY 14620-2913
Phone: (585) 275-5087
Specialties
- Student In An Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1619075413
- Entity Type
- Individual
- Last Name
- Park
- First Name
- Ellen
- Credential
- D.D.S.
- Mailing Street Address
- 625 Elmwood Ave
- Mailing Address Line 2
- Box 683
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14620-2913
- Mailing Country
- US
- Mailing Phone
- (585) 275-5087
- Practice Street Address
- 625 Elmwood Ave
- Practice Address Line 2
- Box 683
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14620-2913
- Practice Country
- US
- Practice Phone
- (585) 275-5087
- Enumeration Date
- September 20, 2006
- Last Updated
- July 08, 2007
- Sex
- Female
- Sole Proprietor
- No
- Taxonomies
- Student In An Organized Health Care Education/Training Program (390200000X)