Organization
PARK DENTAL GROUP INC
Active
Other names
LF Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TAE HOON PARK DDS (CEO)
(909) 543-5075
Entity
Organization
Contact information
Practice address
22611 LAKE FOREST DR, LAKE FOREST, CA 92630-1700
(909) 543-5075
(907) 334-1030
Mailing address
22611 LAKE FOREST DR, LAKE FOREST, CA 92630-1700
(909) 543-5075
(907) 334-1030
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
02/14/2019
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