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Organization
SANGHOON PARK, DDS, INC.
Active
Organization
SANGHOON PARK, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANGHOON PARK DDS (DENTIST/OWNER/PRESIDENT)
(714) 689-2200
Entity
Organization
Contact information
Practice address
13031 KERRY ST, GARDEN GROVE, CA 92844-1638
(714) 689-2200
(714) 689-9112
Mailing address
13031 KERRY ST, GARDEN GROVE, CA 92844-1638
(714) 689-2200
(714) 689-9112
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
54608
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D54608
MEDICAL ID
CA
01
—
G8961601
MEDICAL PROVIDER ID
CA
Enumeration date
11/09/2007
Last updated
05/10/2010
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