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Organization
PARK DENTAL GROUP INC
Active
Organization
PARK DENTAL GROUP INC
Active
Other names
LF Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TAE HOON PARK DDS (CEO)
(909) 543-5075
Entity
Organization
Contact information
Practice address
22611 LAKE FOREST DR, LAKE FOREST, CA 92630-1700
(909) 543-5075
(907) 334-1030
Mailing address
22611 LAKE FOREST DR, LAKE FOREST, CA 92630-1700
(909) 543-5075
(907) 334-1030
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
02/14/2019
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