Organization
DR. D. PARK DDS, INC.
Active
Other names
Smile Dental of Vista
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PARK DDS (OWNER)
(310) 431-1117
Entity
Organization
Contact information
Practice address
1279 E VISTA WAY, VISTA, CA 92084-4039
(760) 208-2518
(760) 340-3464
Mailing address
1279 E VISTA WAY, VISTA, CA 92084-4039
(760) 208-2518
(760) 340-3464
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53724
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53724
—
CA
Enumeration date
08/30/2018
Last updated
08/30/2018
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