Individual
YONG TAE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9184 E STOCKTON BLVD STE A, ELK GROVE, CA 95624-9510
(201) 835-6802
Mailing address
9184 E STOCKTON BLVD STE A, ELK GROVE, CA 95624-9510
(201) 835-6802
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DDS103561
CA
Other
Enumeration date
05/31/2019
Last updated
04/16/2023
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