Park, Andrew C

Park, Andrew C is an individual health care provider with primary practice located at 1591 Griffin Rd , Twenty Nine Palms CA 92278. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Endodontics. Dental Providers / Endodontics is his primary health care specialty. Park, Andrew C can be contacted via phone (760) 830-7054.

Contact Information

Primary practice address
1591 Griffin Rd Twenty Nine Palms CA 92278
Phone: (760) 830-7054
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / Endodontics 1223E0200X 59312 California

Profile Details

NPI number 1407040116
LBN Legal business name Park, Andrew C
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 5th, 2007
Last updated Mar 26th, 2024 - about 2 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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