| Clean Dental | |
|
4402 Gus Thomasson Rd Suite A Mesquite TX 75150-2232 | |
| (214) 765-6212 | |
| Not Available |
| Full Name | Clean Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4402 Gus Thomasson Rd, Mesquite, Texas |
| Authorized Official Name and Position | Sang Woo Park (CEO) |
| Authorized Official Contact | 6145301189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clean Dental 4402 Gus Thomasson Rd Suite A Mesquite TX 75150-2232 Ph: (214) 765-6212 | Clean Dental 4402 Gus Thomasson Rd Suite A Mesquite TX 75150-2232 Ph: (214) 765-6212 |
| NPI Number | 1669777686 |
|---|---|
| Provider Enumeration Date | 01/23/2011 |
| Last Update Date | 12/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669777686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 23653 (Texas) | Primary |
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