| Dream Dental Group | |
|
1518 E. Lincoln Ave. Orange CA 92865 | |
| (714) 998-8998 | |
| (714) 998-0771 |
| Full Name | Dream Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 1518 E. Lincoln Ave., Orange, California |
| Authorized Official Name and Position | Charles C. Park (PRESIDENT) |
| Authorized Official Contact | 7149988998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dream Dental Group 1518 E. Lincoln Ave. Orange CA 92865 Ph: (714) 998-8998 | Dream Dental Group 1518 E. Lincoln Ave. Orange CA 92865 Ph: (714) 998-8998 |
| NPI Number | 1962879387 |
|---|---|
| Provider Enumeration Date | 09/02/2015 |
| Last Update Date | 09/02/2015 |
| Medicare PECOS PAC ID | 5193000123 |
|---|---|
| Medicare Enrollment ID | O20190715001675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962879387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 50087 (California) | Primary |
| Provider Name | Charles Chan-eung Park |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1891865499 PECOS PAC ID: 4284951526 Enrollment ID: I20190715002113 |
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