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General NPI Number Information
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NPI Number | 1518105659
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Entity Type | Organization
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Legal Business Name | CHER Y. CHANG, DMD, P.C.
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 550 S DECATUR BLVD CHARLESTON HEIGHTS SHOPPING CENTER
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City | LAS VEGAS
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State | NV
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Zip | 89107-3911
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Country | US
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Telephone | 702-416-9955
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Fax | 702-416-9957
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Provider Business Mailing Address
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Address Line | 550 S DECATUR BLVD CHARLESTON HEIGHTS SHOPPING CENTER
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City | LAS VEGAS
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State | NV
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Zip | 89107-3911
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Country | US
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Telephone | 702-416-9955
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Fax | 702-416-9957
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | CHER Y CHANG
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Credential | DMD
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Telephone | 702-416-9955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4862
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License Number State | NV
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