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General NPI Number Information
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NPI Number | 1225228091
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Entity Type | Organization
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Legal Business Name | KAO N. VANG, D.M.D. A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | 4304 E ASHLAN AVE
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City | FRESNO
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State | CA
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Zip | 93726-2600
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Country | US
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Telephone | 559-225-9098
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Fax |
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Provider Business Mailing Address
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Address Line | 4304 E ASHLAN AVE
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City | FRESNO
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State | CA
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Zip | 93726-2600
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Country | US
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Telephone | 559-225-9098
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | KAO NHIAWA VANG
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Credential | D.M.D
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Telephone | 559-225-9098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 46148
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License Number State | CA
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