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General NPI Number Information
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NPI Number | 1629366679
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Entity Type | Individual
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Provider Name | CHUAN-MIN HUANG D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2011
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Last Update Date | 07/12/2011
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST SUITE 717
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City | CHICAGO
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State | IL
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Zip | 60612-3841
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Country | US
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Telephone | 312-563-4674
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Fax |
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Provider Business Mailing Address
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Address Line | 445 E OHIO ST APT 2408
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City | CHICAGO
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State | IL
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Zip | 60611-3302
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Country | US
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Telephone | 267-265-1637
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019028697
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License Number State | IL
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