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General NPI Number Information
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NPI Number | 1477038800
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Entity Type | Individual
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Provider Name | MIN SUNG KANG
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Gender | Male
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Dates
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Enumeration Date | 10/02/2018
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 3565 LEE HWY STE S3B
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City | ARLINGTON
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State | VA
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Zip | 22207-3716
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Country | US
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Telephone | 571-447-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 3940 W WHEATLAND RD
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City | DALLAS
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State | TX
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Zip | 75237-3468
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Country | US
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Telephone |
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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 | 34487
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License Number State | TX
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