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Individual
JUN SANG PARK
Active
Individual
JUN SANG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DDS107513
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DDS107513
DENTAL BOARD OF CALIFORNIA
CA
Enumeration date
08/04/2022
Last updated
08/04/2022
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