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Organization
GENE J. PAK DDS CORPORATION
Active
Organization
GENE J. PAK DDS CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENE PAK DDS (PRESIDENT)
(949) 459-7212
Entity
Organization
Contact information
Practice address
28562 OSO PKWY STE K, RANCHO SANTA MARGARITA, CA 92688-5599
(949) 459-7212
Mailing address
28562 OSO PKWY STE K, RANCHO SANTA MARGARITA, CA 92688-5599
(949) 459-7212
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
27207
CA
122300000X
Dentist
53909
CA
122300000X
Dentist
57231
CA
122300000X
Dentist
Primary
59385
CA
1223P0300X
Periodontics
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235392317
NPI - TYPE 1
CA
01
—
1295856060
TYPE 1 - NPI
CA
01
—
1760796023
TYPE 1 - NPI
CA
01
—
1972824589
TYPE 1 NPI
CA
Enumeration date
01/28/2015
Last updated
08/18/2016
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