Healthcare Provider Details

I. General information

NPI: 1194978205
Provider Name (Legal Business Name): DAN BEE KANG DH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2008
Last Update Date: 11/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W COMMERCE ST SUITE 300
SAN ANTONIO TX
78207-3839
US

IV. Provider business mailing address

5253 WALZEM RD
SAN ANTONIO TX
78218-2186
US

V. Phone/Fax

Practice location:
  • Phone: 210-922-0103
  • Fax: 210-922-0162
Mailing address:
  • Phone: 210-651-1050
  • Fax: 210-590-8970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number14608
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: