Ethan Park

NPI 1144779828 · on the registry since 2016 · sole proprietor

Practice

Address: 5728 Rosemead Blvd Unit 220
Temple City, CA 91780
Phone: (626) 500-4340
Fax: (626) 544-5335
Organisation at this address: Ethan Park Dmd Inc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: Dentist
122300000X
Also registered as: General Practice Dentistry
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2023-07-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California