<Unavail>

LBN: D Park Mph Dds Dental Corporation
<Unavail> is an health care organization with primary practice located at 7743 West Ln Ste C5 , Stockton CA 95210-3381. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. D Park Mph Dds Dental Corporation can be contacted via phone (209) 474-1101, or through Park, David Sangho via phone (310) 403-1117.

Contact Information

Primary practice address
7743 West Ln Ste C5 Stockton CA 95210-3381
Phone: (209) 474-1101
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Park, David Sangho DDS, MPH
Phone: (310) 403-1117

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1124572284
LBN Legal business name D Park Mph Dds Dental Corporation
DBA Doing business as <Unavail>
Authorized official Park, David Sangho DDS, MPH
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 6th, 2016
Last updated Jan 11th, 2022 - about 4 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 1124572284 NPPES
California MEDICAID 53724

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