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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. ERIC SONG JOON PARK, D.D.S.

Active Sole Proprietor

DR. ERIC SONG JOON PARK, D.D.S. is a General Dentistry healthcare provider located in SOUTH LAKE TAHOE, California. NPI 1356560916 is currently active in the NPPES registry. Verify at CMS.

General Dentistry · SOUTH LAKE TAHOE, CA

Registration Details

NPI Number
1356560916
Provider Type
Individual
Gender
Male
NPI Issued
Apr 24, 2007 (19.124950905821 yrs)
Last Updated
Jul 8, 2007
Licenses
48533 (CA)
4852 (NV)
Sole Proprietor
Yes

Practice Information

Address
2180 LAKE TAHOE BLVD
SOUTH LAKE TAHOE, CA, 961506418
Browse CA providers · Browse ZIP 96150
Phone
5305413893
Primary Specialty
General Dentistry
1223G0001X
Additional Specialty
General Dentistry

Other General Dentistry Providers in SOUTH LAKE TAHOE, CA

Name Credential NPI
DR. TIMOTHY R DURKIN D.D.S. 1336149970
DR. JEFF CHAMBERLAIN DDS 1043201270
DR. ROSS W. GROELZ DDS 1568437200
DR. CHRIS ALLEN CERCEO D.D.S. 1629091012
DR. JASON RANDALL ACEVEDO DDS 1326127663
DR. DONALD MINEO YAMAOKA DDS 1467526285
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.