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General NPI Number Information
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NPI Number | 1578703864
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Entity Type | Organization
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Legal Business Name | SEUNG M KANG, DDS INC.
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 15892 PASADENA AVE
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City | TUSTIN
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State | CA
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Zip | 92780-5415
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Country | US
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Telephone | 714-573-7100
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Fax | 714-505-0101
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Provider Business Mailing Address
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Address Line | 15892 PASADENA AVE
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City | TUSTIN
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State | CA
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Zip | 92780-5415
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Country | US
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Telephone | 714-573-7100
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Fax | 714-505-0101
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Authorized Official
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Title or Position | OWNER
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Name | DR. SEUNG M KANG
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Credential | DDS
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Telephone | 562-298-7664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 54733
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License Number State | CA
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