National Provider Identifier Database

TRACY S PARK, DDS – NPI #1073615084
General Practice

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.


Contact Information

TRACY S PARK, DDS
2760 3RD STREET
SUITE A
CERES, CA95307
Phone: 209-537-4427
Fax: 209-537-4437
Website:
Specialty Taxonomy Code
* General Practice 1223G0001X

* Indicates primary specialty

NPI Profile & details for TRACY S PARK

NPI Number 1073615084
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 09/01/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 No
Identifiers
  • CA License #: 41769
  • CA Other: B4176901 DENTI-CAL
Hospital affiliation n/a

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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