| College Street Dental Group | |
|
153 W College St Covina CA 91723-2008 | |
| (626) 339-9085 | |
| Not Available |
| Full Name | College Street Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 153 W College St, Covina, California |
| Authorized Official Name and Position | David S Park (DENTIST) |
| Authorized Official Contact | 6263399085 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| College Street Dental Group 153 W College St Covina CA 91723-2008 Ph: (626) 339-9085 | College Street Dental Group 153 W College St Covina CA 91723-2008 Ph: (626) 339-9085 |
| NPI Number | 1538313408 |
|---|---|
| Provider Enumeration Date | 11/05/2008 |
| Last Update Date | 11/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538313408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 53724 (California) | Primary |
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