| Norwalk Dental Group | |
|
12065 Orange St Norwalk CA 90650-4130 | |
| (562) 584-4288 | |
| (562) 584-4488 |
| Full Name | Norwalk Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 12065 Orange St, Norwalk, California |
| Authorized Official Name and Position | David S Park (OWNER) |
| Authorized Official Contact | 5625844288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Norwalk Dental Group 12065 Orange St Norwalk CA 90650-4130 Ph: (562) 584-4288 | Norwalk Dental Group 12065 Orange St Norwalk CA 90650-4130 Ph: (562) 584-4288 |
| NPI Number | 1134550403 |
|---|---|
| Provider Enumeration Date | 12/11/2013 |
| Last Update Date | 04/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134550403 | NPI | - | NPPES |
| 53724 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 53724 (California) | Primary |
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