Individual
ANDREW C PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
43000 MIDWAY AVE BLDG 595, SAN DIEGO, CA 92140-5692
(619) 524-4005
Mailing address
43000 MIDWAY AVE BLDG 595, SAN DIEGO, CA 92140-5692
(619) 524-4005
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
59312
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/05/2007
Last updated
04/02/2026
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