Organization
D SANGHO PARK DDS INC
Active
Other names
Sun Valley Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID S PARK DDS (OWNER)
(310) 403-1117
Entity
Organization
Contact information
Practice address
9375 SAN FERNANDO RD, 6 TH FLOOR, SUN VALLEY, CA 91352-1418
(818) 394-9686
(818) 394-9637
Mailing address
9375 SAN FERNANDO RD, 6 TH FLOOR, SUN VALLEY, CA 91352-1418
(818) 394-9686
(818) 394-9637
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
53724
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53274
—
CA
Enumeration date
11/08/2016
Last updated
11/08/2016
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