Individual
JUSTYN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6522 LONETREE BLVD, ROCKLIN, CA 95765-5874
(916) 773-6565
Mailing address
1714 21ST ST APT 423, SACRAMENTO, CA 95811-6882
(628) 228-7154
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DDS106782
CA
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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