Organization
COLLEGE STREET DENTAL GROUP
Active
Other names
College Street Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID S PARK DDS (DENTIST)
(626) 339-9085
Entity
Organization
Contact information
Practice address
153 W COLLEGE ST, COVINA, CA 91723-2008
(626) 339-9085
Mailing address
153 W COLLEGE ST, COVINA, CA 91723-2008
(626) 339-9085
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53724
CA
Other
Enumeration date
11/05/2008
Last updated
11/05/2008
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