| Gh Park Dds A Dental Corporation | |
|
1031 Rosecrans Ave Ste 104 Fullerton CA 92833-1946 | |
| (714) 530-1948 | |
| (714) 530-1186 |
| Full Name | Gh Park Dds A Dental Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1031 Rosecrans Ave Ste 104, Fullerton, California |
| Authorized Official Name and Position | Gene Park (PRESIDENT) |
| Authorized Official Contact | 3107801296 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gh Park Dds A Dental Corporation 1031 Rosecrans Ave Ste 104 Fullerton CA 92833-1946 Ph: (714) 530-1948 | Gh Park Dds A Dental Corporation 1031 Rosecrans Ave Ste 104 Fullerton CA 92833-1946 Ph: (714) 530-1948 |
| NPI Number | 1780192005 |
|---|---|
| Provider Enumeration Date | 01/22/2018 |
| Last Update Date | 01/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780192005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 49631 (California) | Primary |
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