Organization
CLINTON PARK DENTAL CORPORATION
Active
Other names
Gateway Dental Group and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLINTON H PARK DDS (OWNER DOCTOR)
(760) 431-8112
Entity
Organization
Contact information
Practice address
2635 GATEWAY RD, SUITE 101, CARLSBAD, CA 92009-1753
(760) 431-8112
(760) 929-8776
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/12/2009
Last updated
08/19/2013
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