Bouquet Dental INC

NPI #1679044861 in Lamont, California

Provider Information

NPI Number: 1679044861
Entity Type: Organization
Organization Name: Bouquet Dental INC
Primary Specialty: Dentist
Enumeration Date: Dec 16, 2018
Last Updated: Dec 16, 2018

Practice Location

Address: 8003 ALICANTE AVE
City: Lamont
State: California
ZIP Code: 93241-1712
Phone: (661) 845-2246

Authorized Official

Name: SOO T PARK, DDS
Title: PRESIDENT
Phone: (661) 845-2246

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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