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General NPI Number Information
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NPI Number | 1679929731
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Entity Type | Organization
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Legal Business Name | ERIC C CHIANG DDS
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 1273 W 7TH ST
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City | UPLAND
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State | CA
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Zip | 91786
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Country | US
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Telephone | 909-920-9543
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Fax | 909-949-8013
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Provider Business Mailing Address
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Address Line | 1273 W 7TH ST
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City | UPLAND
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State | CA
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Zip | 91786
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Country | US
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Telephone | 909-920-9543
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Fax | 909-949-8013
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ERIC CHEN CHIANG
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Credential | DDS
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Telephone | 909-920-9543
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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 | 39245
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License Number State | CA
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