Healthcare Provider Details

I. General information

NPI: 1639086358
Provider Name (Legal Business Name): KANG & CO. DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 MAIN ST
ACTON MA
01720-3637
US

IV. Provider business mailing address

255 MAIN ST
ACTON MA
01720-3637
US

V. Phone/Fax

Practice location:
  • Phone: 978-635-9995
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL KANG
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 631-371-9279