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General NPI Number Information
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NPI Number | 1336969898
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Entity Type | Organization
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Legal Business Name | SEOKJOON PANG DDS, INC
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 133 ARCH ST SUITE 4
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City | REDWOOD CITY
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State | CA
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Zip | 94062-1326
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Country | US
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Telephone | 650-549-1155
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Fax | 650-549-6080
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Provider Business Mailing Address
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Address Line | 133 ARCH ST SUITE 4
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City | REDWOOD CITY
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State | CA
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Zip | 94062-1326
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Country | US
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Telephone | 650-549-1155
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Fax | 650-549-6080
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Authorized Official
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Title or Position | CEO
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Name | DR. SEOKJOON PANG
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Credential | DDS
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Telephone | 925-899-7339
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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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