| Dr D S Park Dental Inc | |
|
1245 7th St Wasco CA 93280-1820 | |
| (661) 758-3021 | |
| (661) 758-6780 |
| Full Name | Dr D S Park Dental Inc |
|---|---|
| Speciality | Dentist |
| Location | 1245 7th St, Wasco, California |
| Authorized Official Name and Position | David S Park (OWNER) |
| Authorized Official Contact | 3104031117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr D S Park Dental Inc 1245 7th St Wasco CA 93280-1820 Ph: (661) 758-3021 | Dr D S Park Dental Inc 1245 7th St Wasco CA 93280-1820 Ph: (661) 758-3021 |
| NPI Number | 1760025589 |
|---|---|
| Provider Enumeration Date | 10/24/2019 |
| Last Update Date | 12/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760025589 | NPI | - | NPPES |
| 53724 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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