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General NPI Number Information
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NPI Number | 1821498981
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Entity Type | Organization
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Legal Business Name | HWANG DENTAL CORPORATION
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 3540 WILSHIRE BLVD STE. 210
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City | LOS ANGELES
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State | CA
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Zip | 90010-2307
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Country | US
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Telephone | 213-384-3389
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Fax | 213-381-7770
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Provider Business Mailing Address
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Address Line | 3540 WILSHIRE BLVD STE. 210
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City | LOS ANGELES
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State | CA
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Zip | 90010-2307
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Country | US
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Telephone | 213-384-3389
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Fax | 213-381-7770
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. KENT KI SIK HWANG
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Credential | D.D.S.
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Telephone | 213-384-3389
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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 | 44487
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License Number State | CA
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