| Park Dental Center Professional Llc | |
|
2900 S Peoria St Ste A Aurora CO 80014-3182 | |
| (303) 368-3636 | |
| Not Available |
| Full Name | Park Dental Center Professional Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2900 S Peoria St Ste A, Aurora, Colorado |
| Authorized Official Name and Position | Tae Een Park (OWNER) |
| Authorized Official Contact | 3033683636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Dental Center Professional Llc 2900 S Peoria St Ste A Aurora CO 80014-3182 Ph: (303) 368-3636 | Park Dental Center Professional Llc 2900 S Peoria St Ste A Aurora CO 80014-3182 Ph: (303) 368-3636 |
| NPI Number | 1457455966 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457455966 | NPI | - | NPPES |
| 02270781 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8962 (Colorado) | Primary |
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