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General NPI Number Information
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NPI Number | 1730295890
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Entity Type | Individual
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Provider Name | YURIC JUI-SHIH CHANG DMD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 105 N MAIN ST
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City | LEOMINSTER
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State | MA
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Zip | 01453-5507
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Country | US
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Telephone | 978-537-3570
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Fax | 978-537-7743
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Provider Business Mailing Address
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Address Line | 105 N MAIN ST
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City | LEOMINSTER
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State | MA
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Zip | 01453-5507
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Country | US
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Telephone | 978-537-3570
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Fax | 978-537-7743
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18617MA
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License Number State | ME
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