Organization
M PARK DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL H PARK DDS (OWNER/PRESIDENT)
(310) 901-2300
Entity
Organization
Contact information
Practice address
23326 HAWTHORNE BLVD STE 320, TORRANCE, CA 90505-3760
(310) 901-2300
Mailing address
23326 HAWTHORNE BLVD STE 320, TORRANCE, CA 90505-3760
(310) 901-2300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106120
DENTIST
CA
Enumeration date
01/24/2023
Last updated
01/24/2023
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