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Organization
HO,NGUYEN,PARK DENTAL CORPORATION
Active
Organization
HO,NGUYEN,PARK DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIM PARK (DDS/CEO OWNER)
(951) 324-8180
Entity
Organization
Contact information
Practice address
4710 LA SIERRA AVE, RIVERSIDE, CA 92505-2777
(951) 324-8180
Mailing address
4710 LA SIERRA AVE, RIVERSIDE, CA 92505-2777
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
47545
CA
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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