| NPI | 1679538037 |
|---|---|
| Doing Business As | PARK DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | SOO TAE PARK Owner President 661-948-1655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 33967) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 22315) |
| 122300000X Dentist (Licence: CA 16496) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2013-10-09 |