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General NPI Number Information
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NPI Number | 1194394700
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Entity Type | Organization
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Legal Business Name | KAI CHANG D.D.S., INC.
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Dates
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Enumeration Date | 06/18/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 1237 N GRAND AVE
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City | WALNUT
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State | CA
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Zip | 91789-1343
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Country | US
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Telephone | 909-594-7027
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Fax |
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Provider Business Mailing Address
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Address Line | 1237 N GRAND AVE
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City | WALNUT
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State | CA
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Zip | 91789-1343
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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 | PRESIDENT
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Name | KAI CHANG
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Credential | DDS
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Telephone | 949-307-0477
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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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