| Dawnelle Park Dds, Inc. | |
|
3655 Lomita Blvd Ste 304 Torrance CA 90505-1925 | |
| (310) 303-3860 | |
| (310) 303-3868 |
| Full Name | Dawnelle Park Dds, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 3655 Lomita Blvd Ste 304, Torrance, California |
| Authorized Official Name and Position | Dawnelle Park (OWNER/DENTIST) |
| Authorized Official Contact | 3103033860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dawnelle Park Dds, Inc. 3655 Lomita Blvd Ste 304 Torrance CA 90505-1925 Ph: (310) 303-3860 | Dawnelle Park Dds, Inc. 3655 Lomita Blvd Ste 304 Torrance CA 90505-1925 Ph: (310) 303-3860 |
| NPI Number | 1093252470 |
|---|---|
| Provider Enumeration Date | 01/24/2017 |
| Last Update Date | 01/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093252470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 124Q00000X | Dental Hygienist | (* (Not Available)) | Secondary |
| 126800000X | Dental Assistant | (* (Not Available)) | Secondary |
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