Organization
BOUQUET DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOO T PARK DDS (PRESIDENT)
(661) 845-2246
Entity
Organization
Contact information
Practice address
8003 ALICANTE AVE, LAMONT, CA 93241-1712
(661) 845-2246
Mailing address
8003 ALICANTE AVE, LAMONT, CA 93241-1712
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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