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General NPI Number Information
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NPI Number | 1508372269
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Entity Type | Organization
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Legal Business Name | DONG-GIL KANG DDS INC
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Dates
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Enumeration Date | 12/18/2017
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 1414 W COLORADO BLVD
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City | PASADENA
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State | CA
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Zip | 91105-1414
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Country | US
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Telephone | 626-714-7877
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Fax | 626-714-7876
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Provider Business Mailing Address
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Address Line | 668 N LOS ROBLES AVE
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City | PASADENA
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State | CA
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Zip | 91101-1004
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Country | US
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Telephone | 626-714-7877
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Fax | 626-714-7876
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Authorized Official
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Title or Position | CEO/DOCTOR
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Name | DONGGIL KANG
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Credential | D.D.S
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Telephone | 909-912-4270
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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 | 64566
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License Number State | CA
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