Park, Yong Tae

Park, Yong Tae is an individual health care provider with primary practice located at 9184 E Stockton Blvd Ste A , Elk Grove CA 95624-9510. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Park, Yong Tae can be contacted via phone (201) 835-6802.

Contact Information

Primary practice address
9184 E Stockton Blvd Ste A Elk Grove CA 95624-9510
Phone: (201) 835-6802
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X DDS103561 California

Profile Details

NPI number 1952969354
LBN Legal business name Park, Yong Tae
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2019
Last updated Apr 16th, 2023 - about last year

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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