Individual
MRS. JEANETTE GENKYUNG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
6350 W RAMSEY ST, SUITE A, BANNING, CA 92220-3062
(951) 769-0466
(951) 769-3606
Mailing address
6350 W RAMSEY ST, SUITE A, BANNING, CA 92220-3062
(951) 769-0466
(951) 769-3606
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
23312
CA
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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