Organization
CLEAN DENTAL OF DALLAS, P.C.
Active
Other names
Clean Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANG W PARK DDS (CEO)
(214) 765-6213
Entity
Organization
Contact information
Practice address
4907 SPRING AVE, DALLAS, TX 75210-1360
(214) 765-6212
Mailing address
4402 GUS THOMASSON RD, SUITE A, MESQUITE, TX 75150-2232
(214) 765-6212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23653
TX
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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