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Organization
S PARK DDS INC
Active
Organization
S PARK DDS INC
Active
Parent organization
S PARK DDS INC
Other names
Smile Dental of South Sacramento
Organization subpart
Yes
Provider details
NPI number
Legal business name
S PARK DDS INC
Authorized official
DAVID S PARK (DENTIST/OWNER)
(310) 403-1117
Entity
Organization
Contact information
Practice address
6163 MACK RD, SACRAMENTO, CA 95823-4654
(888) 585-3368
(661) 471-2121
Mailing address
6163 MACK RD, SACRAMENTO, CA 95823-4654
(888) 585-3368
(661) 471-2121
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53724
—
CA
Enumeration date
12/04/2020
Last updated
12/04/2020
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