| Daniel C. Park Dds Inc | |
| 
					1202 Beaumont Ave Beaumont CA 92223-1506  | |
| (951) 845-2661 | |
| (888) 462-1262 | 
| Full Name | Daniel C. Park Dds Inc | 
|---|---|
| Speciality | Dentist | 
| Location | 1202 Beaumont Ave, Beaumont, California | 
| Authorized Official Name and Position | Daniel Park (PRESIDENT) | 
| Authorized Official Contact | 9518452661 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Daniel C. Park Dds Inc 1202 Beaumont Ave Beaumont CA 92223-1506 Ph: (951) 845-2661  | Daniel C. Park Dds Inc 1202 Beaumont Ave Beaumont CA 92223-1506 Ph: (951) 845-2661  | 
| NPI Number | 1073988341 | 
|---|---|
| Provider Enumeration Date | 12/11/2015 | 
| Last Update Date | 12/11/2015 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1073988341 | NPI | - | NPPES | 
| 1598803116 | Other | CA | TYPE 1 NPI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 122300000X | Dentist | 47983 (California) | Primary | 
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