Individual
JI YONG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
100 E VALENCIA MESA DR, SUITE 209, FULLERTON, CA 92835-3813
(714) 871-0500
(714) 871-0510
Mailing address
100 E VALENCIA MESA DR, SUITE 209, FULLERTON, CA 92835-3813
(714) 871-0500
(714) 871-0510
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
44525
CA
Other
Enumeration date
12/05/2006
Last updated
09/29/2008
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