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General NPI Number Information
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NPI Number | 1083427744
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Entity Type | Organization
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Legal Business Name | CHANG W RHIM DDS INC
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 1730 CALUMET AVE
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City | WHITING
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State | IN
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Zip | 46394-1415
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Country | US
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Telephone | 219-659-2776
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Fax |
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Provider Business Mailing Address
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Address Line | 3726 MAIN ST
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City | EAST CHICAGO
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State | IN
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Zip | 46312-2224
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | CHANG RHIM
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Credential | DDS
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Telephone | 219-378-1450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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