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General NPI Number Information
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NPI Number | 1417276296
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Entity Type | Individual
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Provider Name | CHEN TSUNG CHANG D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 05/19/2010
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Provider Practice Location Address
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Address Line | 300 S GARFIELD AVE # 203
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City | MONTEREY PARK
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State | CA
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Zip | 91754-3336
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Country | US
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Telephone | 626-226-3555
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Fax |
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Provider Business Mailing Address
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Address Line | 300 S. GARFIELD AVENUE #203
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City | MONTEREY PARK
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State | CA
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Zip | 91754
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Country | US
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Telephone | 626-226-3555
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Fax |
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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 | 59262
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License Number State | CA
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