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16709 Hawthorne Blvd Lawndale CA 90260-3244 | |
| (310) 542-5558 | |
| (310) 542-4309 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 16709 Hawthorne Blvd, Lawndale, California |
| Authorized Official Name and Position | Sunghae Park (DENTIST/OWNER) |
| Authorized Official Contact | 3105425558 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
16709 Hawthorne Blvd Lawndale CA 90260-3244 Ph: (310) 542-5558 | 16709 Hawthorne Blvd Lawndale CA 90260-3244 Ph: (310) 542-5558 |
| NPI Number | 1457664070 |
|---|---|
| Provider Enumeration Date | 07/24/2010 |
| Last Update Date | 07/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457664070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 57834 (California) | Primary |
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