Organization
D PARK PROFESSIONAL DENTAL CORP
Active
Other names
Children & Adult Dentistry- Santa Ana
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PARK DDS (OWNER)
(714) 210-0169
Entity
Organization
Contact information
Practice address
512 W 17TH ST STE B, SANTA ANA, CA 92706-3678
(714) 210-0169
(714) 972-0162
Mailing address
512 W 17TH ST STE B, SANTA ANA, CA 92706-3678
(714) 210-0169
(714) 972-0162
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
53724
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53724
—
CA
Enumeration date
05/12/2018
Last updated
05/12/2018
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