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Contact Information

SOO T PARK, DDS
44841 N 10TH ST W
LANCASTER, CA93534
 Phone: 661-948-1655
 Fax: 661-940-9636
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for SOO T PARK · (Male)

NPI # 1124084728
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 04/22/2006
Last updated 10/09/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 33967
  • CA Medicaid G9225701
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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