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General NPI Number Information
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NPI Number | 1427556885
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Entity Type | Organization
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Legal Business Name | BETTER CHOICE DENTAL
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 3760 W MCFADDEN AVE STE D
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City | SANTA ANA
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State | CA
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Zip | 92704-1392
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Country | US
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Telephone | 657-231-6106
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Fax |
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Provider Business Mailing Address
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Address Line | 3760 W MCFADDEN AVE STE D
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City | SANTA ANA
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State | CA
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Zip | 92704-1392
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Country | US
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Telephone | 657-231-6106
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAE WOO CHUNG
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Credential | D.M.D.
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Telephone | 657-231-6106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 53122
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License Number State | CA
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