Organization
D PARK MPH DDS DENTAL CORPORATION
Active
Parent organization
D PARK MPH DDS DENTAL CORPORATION
Other names
Pacific Dental Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
D PARK MPH DDS DENTAL CORPORATION
Authorized official
MR. DAVID SANGHO PARK DDS, MPH (CEO, CFO)
(310) 403-1117
Entity
Organization
Contact information
Practice address
7743 WEST LN STE C5, STOCKTON, CA 95210-3381
(209) 474-1101
Mailing address
7743 WEST LN STE C5, STOCKTON, CA 95210-3381
(209) 474-1101
(209) 474-9734
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53724
—
CA
Enumeration date
08/06/2016
Last updated
01/11/2022
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