| Taehoon Park DDS Inc | |
|
20162 Us Highway 18 Ste L Apple Valley CA 92307-2935 | |
| (760) 946-1466 | |
| (760) 946-1956 |
| Full Name | Taehoon Park DDS Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 20162 Us Highway 18 Ste L, Apple Valley, California |
| Authorized Official Name and Position | Tae-hoon Park (PRESIDENT) |
| Authorized Official Contact | 7609461466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Taehoon Park DDS Inc 20162 Us Highway 18 Ste L Apple Valley CA 92307-2935 Ph: (760) 946-1466 | Taehoon Park DDS Inc 20162 Us Highway 18 Ste L Apple Valley CA 92307-2935 Ph: (760) 946-1466 |
| NPI Number | 1659752731 |
|---|---|
| Provider Enumeration Date | 06/15/2015 |
| Last Update Date | 06/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659752731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 56079 (California) | Primary |
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