Individual provider · Type 1 NPI

Joseph Park, DDS, MD

Oral and Maxillofacial Surgery (Dentist) · Fort Bragg, NC

NPI number 1639532104 Active

Practice location

2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001

Call (910) 907-6000 Map

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X13022 (NC)
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X13022 (NC)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1639532104

Joseph Park, DDS, MD's National Provider Identifier is 1639532104, issued on Apr 1, 2016. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Fort Bragg, NC. The record was last updated on Dec 8, 2025.