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Organization
DR PARK DENTAL CORPORATION
Active
Organization
DR PARK DENTAL CORPORATION
Active
Other names
West AV Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID PARK DDS (CEO)
(310) 403-1117
Entity
Organization
Contact information
Practice address
38745 TIERRA SUBIDA AVE STE 150, PALMDALE, CA 93551-4567
(661) 272-9091
Mailing address
1669 W AVENUE J STE 305, LANCASTER, CA 93534-2870
(661) 802-7544
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53724
CA
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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