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General NPI Number Information
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NPI Number | 1790295632
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Entity Type | Organization
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Legal Business Name | S. JANG DDS INCORPORATED
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Dates
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Enumeration Date | 10/05/2017
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 500 AUBURN FOLSOM RD STE 330B
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City | AUBURN
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State | CA
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Zip | 95603-5645
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Country | US
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Telephone | 916-984-4224
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Fax |
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Provider Business Mailing Address
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Address Line | 2260 E BIDWELL ST SUITE # 359
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City | FOLSOM
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State | CA
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Zip | 95630-3555
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Country | US
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Telephone | 916-781-6550
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MEGAN CASTILLO
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Credential |
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Telephone | 916-781-6550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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