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1831614213
SAM S PARK
CORONA, CA
NPI
1831614213
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: CA DDS101611)
Enumeration Date
2017-08-07
Last Update Date
2018-03-17
Business Address
SAM S PARK DMD
1222 MAGNOLIA AVE STE 101
CORONA, CA 92881-2075
Phone number: 909-256-0456
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Mailing Address
SAM S PARK DMD
5555 CRESTRIDGE RD APT 210
RANCHO PALOS VERDES, CA 90275-3580
Phone number: 310-344-8893
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