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General NPI Number Information
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NPI Number | 1508061524
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Entity Type | Organization
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Legal Business Name | JUSTIN D. HWANG, DDS, INC
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 7208 PACIFIC BLVD STE 200
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-5770
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Country | US
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Telephone | 323-582-2200
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Fax | 323-582-2882
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Provider Business Mailing Address
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Address Line | 7208 PACIFIC BLVD STE 200
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-5770
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Country | US
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Telephone | 323-582-2200
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Fax | 323-582-2882
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUSTIN D HWANG
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Credential | D.D.S
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Telephone | 323-582-2200
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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 | 35273
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License Number State | CA
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