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Organization
SANGHO PARK DDS INC.
Active
Organization
SANGHO PARK DDS INC.
Active
Other names
Premier Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID S PARK DDS (DENTIST)
(310) 403-1117
Entity
Organization
Contact information
Practice address
3517 MARCONI AVE STE 104 AND 105, SACRAMENTO, CA 95821
(310) 403-1117
Mailing address
3517 MARCONI AVE STE 104 AND 105, SACRAMENTO, CA 95821
(310) 403-1117
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53724
CA
Other
Enumeration date
06/23/2014
Last updated
06/23/2014
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