Individual
ASHLEY PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5731 E SANTA ANA CANYON RD STE A, ANAHEIM, CA 92807-3234
(714) 998-2956
Mailing address
5731 E SANTA ANA CANYON RD STE A, ANAHEIM, CA 92807-3234
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
100695
CA
Other
Enumeration date
08/14/2016
Last updated
12/08/2021
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