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Organization

DAVID S PARK DDS INC

Active
Other names
El Centro Dental Group
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID S PARK DDS (OWNER)
(310) 403-1117
Entity
Organization

Contact information

Practice address
617 S 8TH ST, EL CENTRO, CA 92243-3218
(760) 312-5888
(760) 312-5918
Mailing address
617 S 8TH ST, EL CENTRO, CA 92243-3218
(760) 312-5888
(760) 312-5918

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53724
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
53724
CA
Enumeration date
08/13/2014
Last updated
12/04/2020
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