Ethan Sb Park

NPI #1144779828 in Temple City, California

Provider Information

NPI Number: 1144779828
Entity Type: Individual
Name: Ethan Sb Park
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Sep 23, 2016
Last Updated: Jul 12, 2023

Practice Location

Address: 5728 ROSEMEAD BLVD UNIT 220
City: Temple City
State: California
ZIP Code: 91780-1814
Phone: (626) 500-4340

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X
Dentist	122300000X	Primary

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