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General NPI Number Information
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NPI Number | 1255503298
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Entity Type | Individual
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Provider Name | STEPHEN M FUANG DDS, MSD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 03/31/2008
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Provider Practice Location Address
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Address Line | 700 N DIAMOND BAR BLVD STE B
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1060
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Country | US
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Telephone | 909-612-0999
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Fax | 909-612-0998
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Provider Business Mailing Address
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Address Line | 700 N DIAMOND BAR BLVD STE B
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1060
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Country | US
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Telephone | 909-612-0999
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Fax | 909-612-0998
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 32958
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License Number State | CA
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