Park, Tina Keun Nan
Park, Tina Keun Nan is an sole proprietor health care provider with primary practice located at 962 Calle Amable , Glendale CA 91208-3062. She recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as her primary health care specialty. Park, Tina Keun Nan can be contacted via phone (323) 369-4054.Contact Information
Primary practice address
962 Calle Amable
Glendale CA 91208-3062
Phone: (323) 369-4054
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 63253 | California |
Profile Details
| NPI number | 1407200694 |
|---|---|
| LBN Legal business name | Park, Tina Keun Nan |
| Credentials | D.D.S., M.S. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 14th, 2016 |
| Last updated | Apr 14th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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