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Organization
JAEIN PARK DDS INC
Active
Organization
JAEIN PARK DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAEIN PARK DDS (C.E.O.)
(909) 593-5140
Entity
Organization
Contact information
Practice address
2048 ORANGE TREE LN STE 100, REDLANDS, CA 92374-4566
(909) 953-5140
Mailing address
25519 CARROL CT, LOMA LINDA, CA 92354-3700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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