Most Relevant Information
Provider Data
| NPI Number: | 1003394313 |
| Provider Name: | JONGGOO PARK DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 102883 |
Most Important Dates
| Enumeration Date: | 07/30/2018 |
| Last Updated: | 03/04/2022 |
Provider Practice Location
18444 BROOKHURST ST
FOUNTAIN VALLEY
CA
927086706
Practice Location Phone/Fax
| Phone: | 7149622471 |
| Fax: | 7149686411 |
Provider Mailing Location
18444 BROOKHURST ST
FOUNTAIN VALLEY
CA
927086706
Provider Mailing Phone/Fax
| Phone: | 7149622471 |
| Fax: | 7149686411 |