Organization
D PARK MPH DENTAL, INC
Active
Other names
HP 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
5802 PACIFIC BLVD, HUNTINGTON PARK, CA 90255-2618
(310) 403-1117
Mailing address
5802 PACIFIC BLVD, HUNTINGTON PARK, CA 90255-2618
(310) 403-1117
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
53724
CA
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53724
—
CA
Enumeration date
05/19/2016
Last updated
12/04/2020
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