D Park Mph DDS Dental Corporation
NPI #1609450006 in Tracy, California
Provider Information
- NPI Number
- 1609450006
- Entity Type
- Organization
- Organization Name
- D Park Mph DDS Dental Corporation
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- D PARK MPH DDS DENTAL CORPORATION
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 11, 2021
- Last Updated
- May 12, 2021
Practice Location
- Address
- 2616 PAVILION PKWY STE 104
- City
- Tracy
- State
- California
- ZIP Code
- 95304-9408
- Phone
- (209) 839-8333
Authorized Official
- Name
- DAVID S PARK
- Title
- DDS/CEO
- Phone
- (310) 403-1117
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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