| Jc Park Dental Group, Inc. | |
|
15201 S Western Ave Gardena CA 90249-4314 | |
| (310) 400-7705 | |
| (310) 400-7714 |
| Full Name | Jc Park Dental Group, Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15201 S Western Ave, Gardena, California |
| Authorized Official Name and Position | Jaechan Park (PRESIDENT) |
| Authorized Official Contact | 6264540159 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jc Park Dental Group, Inc. 614 Inverness Ct Fullerton CA 92835-2776 Ph: (626) 454-0159 | Jc Park Dental Group, Inc. 15201 S Western Ave Gardena CA 90249-4314 Ph: (310) 400-7705 |
| NPI Number | 1215638713 |
|---|---|
| Provider Enumeration Date | 03/13/2023 |
| Last Update Date | 03/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215638713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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