Park Dental Group INC
NPI #1952877854 in Lake Forest, California
Provider Information
- NPI Number
- 1952877854
- Entity Type
- Organization
- Organization Name
- Park Dental Group INC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Oct 17, 2018
- Last Updated
- Feb 14, 2019
Practice Location
- Address
- 22611 LAKE FOREST DR
- City
- Lake Forest
- State
- California
- ZIP Code
- 92630-1700
- Phone
- (909) 543-5075
Authorized Official
- Name
- TAE HOON PARK, DDS
- Title
- CEO
- Phone
- (909) 543-5075
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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