Park Dental Group

LBN: Soo T Park Dds Inc
Park Dental Group is an health care organization with primary practice located at 44841 N 10Th St W , Lancaster CA 93534. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Soo T Park Dds Inc can be contacted via phone (661) 948-1655, or through Park, Soo Tae via phone (661) 948-1655.

Contact Information

Primary practice address
44841 N 10Th St W Lancaster CA 93534
Phone: (661) 948-1655
Fax: (661) 940-9636
Website:
Map and Directions
Authorized official contact:
Name: Park, Soo Tae Doctor of Dental Surgery (DDS)
Phone: (661) 948-1655

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 33967 California
Dental Providers / Dentist 122300000X 22315 California
Dental Providers / Dentist 122300000X 16496 California

Profile Details

NPI number 1679538037
LBN Legal business name Soo T Park Dds Inc
DBA Doing business as Park Dental Group
Authorized official Park, Soo Tae Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 19th, 2006
Last updated Oct 9th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679538037 NPPES
California MEDICAID G9225701

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