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General NPI Number Information
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NPI Number | 1174904825
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Entity Type | Organization
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Legal Business Name | PING-LIN BEN CHUNG, DDS, DMSC, INC
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 4200 CHINO HILLS PKWY STE 860
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City | CHINO HILLS
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State | CA
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Zip | 91709-3784
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Country | US
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Telephone | 909-393-5688
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Fax | 909-393-5288
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Provider Business Mailing Address
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Address Line | 4200 CHINO HILLS PKWY STE 860
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City | CHINO HILLS
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State | CA
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Zip | 91709-3784
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Country | US
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Telephone | 909-393-5688
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Fax | 909-393-5288
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PING-LIN BEN CHUNG
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Credential | DDS, DMSC
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Telephone | 310-460-8348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 54943
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License Number State | CA
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