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General NPI Number Information
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NPI Number | 1376052530
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Entity Type | Organization
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Legal Business Name | HUANG DDS, DENTAL CORP
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Dates
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Enumeration Date | 09/20/2017
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 1641 EL CAMINO REAL 100
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City | MILLBRAE
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State | CA
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Zip | 94030-1269
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Country | US
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Telephone | 650-989-8711
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Fax |
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Provider Business Mailing Address
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Address Line | 8074 PARK VILLA CIR
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City | CUPERTINO
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State | CA
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Zip | 95014-4064
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Country | US
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Telephone | 14088285567
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH HUANG
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Credential | DDS
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Telephone | 408-828-5567
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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 | 25907
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License Number State | CA
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