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Organization
DR. D. PARK DDS, INC.
Active
Organization
DR. D. PARK DDS, INC.
Active
Other names
Smile Dental of Vista
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PARK DDS (OWNER)
(310) 431-1117
Entity
Organization
Contact information
Practice address
1279 E VISTA WAY, VISTA, CA 92084-4039
(760) 208-2518
(760) 340-3464
Mailing address
1279 E VISTA WAY, VISTA, CA 92084-4039
(760) 208-2518
(760) 340-3464
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53724
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53724
—
CA
Enumeration date
08/30/2018
Last updated
08/30/2018
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