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Organization
JC PARK DENTAL GROUP, INC.
Active
Organization
JC PARK DENTAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAECHAN PARK (PRESIDENT)
(626) 454-0159
Entity
Organization
Contact information
Practice address
15201 S WESTERN AVE, GARDENA, CA 90249-4314
(310) 400-7705
(310) 400-7714
Mailing address
614 INVERNESS CT, FULLERTON, CA 92835-2776
(626) 454-0159
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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