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Organization
SALIDA DENTAL GROUP
Active
Organization
SALIDA DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID S PARK DDS (DENTIST)
(310) 403-1117
Entity
Organization
Contact information
Practice address
5708 PIRRONE RD, SALIDA, CA 95368-9313
(209) 543-3888
Mailing address
5708 PIRRONE RD, SALIDA, CA 95368-9313
(209) 543-3888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53724
CA
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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