Healthcare Provider Details
I. General information
NPI: 1891830022
Provider Name (Legal Business Name): DANIEL C. HUANG D.D.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2007
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3991 MACARTHUR BLVD SUITE 228
NEWPORT BEACH CA
92660-3058
US
IV. Provider business mailing address
3991 MACARTHUR BLVD SUITE 228
NEWPORT BEACH CA
92660-3058
US
V. Phone/Fax
- Phone: 949-863-0988
- Fax: 949-863-0088
- Phone: 949-863-0988
- Fax: 949-863-0088
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 35907 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
DANIEL
C
HUANG
Title or Position: PRESIDENT
Credential: DDS
Phone: 949-863-0988