Park, Jae Sung
Park, Jae Sung is an individual health care provider with primary practice located at 1578 Constitution Blvd Suite 01, Rock Hill SC 29732-3543. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Park, Jae Sung can be contacted via phone (803) 366-1456.Contact Information
Primary practice address
1578 Constitution Blvd Suite 01
Rock Hill SC 29732-3543
Phone: (803) 366-1456
Fax: (803) 324-0117
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DGD.8288 GD | South Carolina |
Profile Details
| NPI number | 1134551716 |
|---|---|
| LBN Legal business name | Park, Jae Sung |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 6th, 2013 |
| Last updated | Dec 24th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134551716 | NPPES |
| South Carolina | MEDICAID | ZX8288 |
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