Organization
DANIEL C. PARK DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL PARK DDS (PRESIDENT)
(951) 845-2661
Entity
Organization
Contact information
Practice address
1202 BEAUMONT AVE, BEAUMONT, CA 92223-1506
(951) 845-2661
(888) 462-1262
Mailing address
1202 BEAUMONT AVE, BEAUMONT, CA 92223-1506
(951) 845-2661
(888) 462-1262
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
47983
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598803116
TYPE 1 NPI
CA
Enumeration date
12/11/2015
Last updated
12/11/2015
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