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3517 Marconi Ave Ste 104 And 105 Sacramento CA 95821 | |
| (310) 403-1117 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 3517 Marconi Ave Ste 104 And 105, Sacramento, California |
| Authorized Official Name and Position | David S Park (DENTIST) |
| Authorized Official Contact | 3104031117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3517 Marconi Ave Ste 104 And 105 Sacramento CA 95821 Ph: (310) 403-1117 | 3517 Marconi Ave Ste 104 And 105 Sacramento CA 95821 Ph: (310) 403-1117 |
| NPI Number | 1124433750 |
|---|---|
| Provider Enumeration Date | 06/23/2014 |
| Last Update Date | 06/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124433750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 53724 (California) | Primary |
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