| Tae Een Park,d.d.s.,inc | |
|
190 S Oak Ave Ste 6 Oakdale CA 95361-3528 | |
| (209) 847-2800 | |
| (209) 847-2929 |
| Full Name | Tae Een Park,d.d.s.,inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 190 S Oak Ave Ste 6, Oakdale, California |
| Authorized Official Name and Position | Tae Een Park (CEO) |
| Authorized Official Contact | 2098472800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tae Een Park,d.d.s.,inc 190 S. Oak Ave Bldg 3 Ste 6 Oakdale CA 95361 Ph: (209) 847-2800 | Tae Een Park,d.d.s.,inc 190 S Oak Ave Ste 6 Oakdale CA 95361-3528 Ph: (209) 847-2800 |
| NPI Number | 1063889558 |
|---|---|
| Provider Enumeration Date | 08/31/2015 |
| Last Update Date | 08/31/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063889558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 56889 (California) | Primary |
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