# DR D S PARK DENTAL INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DR D S PARK DENTAL INC
- **Other names:** Smile Dental of Delano
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477196244
- **Legal business name:** DR D S PARK DENTAL INC
- **Authorized official:** DAVID S PARK DDS (OWNER)
- **Authorized official phone:** (310) 403-1117

## Contact information

- **Practice address:** 1406 JEFFERSON ST, DELANO, CA 93215-2222
- **Practice address phone:** (661) 725-9430
- **Practice address fax:** (661) 725-7221
- **Mailing address:** 1406 JEFFERSON ST, DELANO, CA 93215-2222
- **Mailing address phone:** (661) 725-9430
- **Mailing address fax:** (661) 725-7221

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2019
- **Last updated:** 01/06/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 53724 | — | CA |