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General NPI Number Information
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NPI Number | 1326145509
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Entity Type | Organization
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Legal Business Name | CHEUNG PROFESSIONAL DENTAL CORP.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 1283 22ND AVE. 2ND FLOOR
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-1601
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Country | US
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Telephone | 415-753-9888
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Fax | 415-753-9688
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Provider Business Mailing Address
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Address Line | 1283 22ND AVE. 2ND FLOOR
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-1601
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Country | US
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Telephone | 415-753-9888
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Fax | 415-753-9688
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATRICK H CHEUNG
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Credential | D.D.S.
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Telephone | 415-399-8888
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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 | 33734
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License Number State | CA
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