Sanghoon Park, Dds, Inc. | |
13031 Kerry St Garden Grove CA 92844-1638 | |
(714) 689-2200 | |
(714) 689-9112 |
Full Name | Sanghoon Park, Dds, Inc. |
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Speciality | Clinic/center - Dental |
Location | 13031 Kerry St, Garden Grove, California |
Authorized Official Name and Position | Sanghoon Park (DENTIST/OWNER/PRESIDENT) |
Authorized Official Contact | 7146892200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Sanghoon Park, Dds, Inc. 13031 Kerry St Garden Grove CA 92844-1638 Ph: (714) 689-2200 | Sanghoon Park, Dds, Inc. 13031 Kerry St Garden Grove CA 92844-1638 Ph: (714) 689-2200 |
NPI Number | 1770763468 |
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Provider Enumeration Date | 11/09/2007 |
Last Update Date | 05/10/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770763468 | NPI | - | NPPES |
D54608 | Other | CA | MEDICAL ID |
G8961601 | Other | CA | MEDICAL PROVIDER ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 54608 (California) | Primary |
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