| NPI | 1538313408 |
|---|---|
| Doing Business As | COLLEGE STREET DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DAVID S PARK Dentist 626-339-9085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 53724) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2008-11-05 |