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Aidan Park, DDS
NPI 1639626450 · on the registry since 2016 · sole proprietor
Practice
- Address
- 6430 Green Bay Rd
Kenosha, WI 53142 - Phone
- (888) 988-4066
- Fax
- (847) 496-4850
- Organisation at this address
- Familia Dental Kenosha Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 11
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-09-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin