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Organization
CHAN M. PARK, D.D.S., M.D., PC AND BENJAMIN R. SHIMEL, D.D.S., PC A PA
Active
Organization
CHAN M. PARK, D.D.S., M.D., PC AND BENJAMIN R. SHIMEL, D.D.S., PC A PA
Active
Other names
Sycamore Oral & Maxillofacial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
CHAN M PARK MD, DDS (PARTNER)
(925) 217-4884
Entity
Organization
Contact information
Practice address
111 DEERWOOD RD STE 130, SAN RAMON, CA 94583-2194
(925) 217-4884
(925) 217-4895
Mailing address
111 DEERWOOD RD STE 130, SAN RAMON, CA 94583-2194
(925) 217-4884
(925) 217-4895
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/11/2019
Last updated
10/11/2019
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