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Aidan Park, DDS — NPI 1639626450, Kenosha, WI | NPI Central

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NPI 1639626450

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Aidan Park, DDS

NPI 1639626450 · Dentist · Kenosha, WI

Provider details

NPI number: 1639626450
Entity type: Individual
Primary specialty: DentistDental Providers
Credential: DDS
Sex: Male
Sole proprietor: Yes
License: 1001421 (WI)

Specialties & taxonomies

DentistPrimary122300000XLicense 1001421 (WI)
Dental Providers

Practice location

6430 Green Bay Rd

Kenosha, WI 53142-2948

Phone: (888) 988-4066

Fax: (847) 496-4850

Approximate (ZIP-level) locationGet directions

More WI providers

Mailing address

2050 E Algonquin Rd

Schaumburg, IL 60173-4144

Registry dates

Enumerated: 2016-09-09
Last updated: 2016-09-09

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.