Most Relevant Information
Provider Data
| NPI Number: | 1003037813 |
| Provider Name: | TINA MIEUN PARK-LEE D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 40976 |
Most Important Dates
| Enumeration Date: | 05/01/2007 |
| Last Updated: | 09/12/2013 |
Provider Practice Location
26554 AMHERST CT
LOMA LINDA
CA
923546732
Practice Location Phone/Fax
| Phone: | 9097698077 |
| Fax: |
Provider Mailing Location
26554 AMHERST CT
LOMA LINDA
CA
923546732
Provider Mailing Phone/Fax
| Phone: | 9097698077 |
| Fax: |