Organization
VALLEY ACE DENTAL GROUP JOINT
Active
Other names
Valley Ace Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MINDY PARK DDS (GENERAL DENTIST)
(818) 576-9990
Entity
Organization
Contact information
Practice address
8345 RESEDA BLVD STE 101, NORTHRIDGE, CA 91324-4648
(818) 576-9990
(818) 576-9993
Mailing address
8345 RESEDA BLVD STE 101, NORTHRIDGE, CA 91324-4648
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
54241
CA
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
08/22/2011
Last updated
10/11/2023
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