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General NPI Number Information
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NPI Number | 1902453533
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Entity Type | Individual
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Provider Name | DAVID KANG
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Gender | Male
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 501 W 1ST AVE
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City | TOPPENISH
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State | WA
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Zip | 98948-1565
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Country | US
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Telephone | 509-865-5600
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Fax | 509-865-5783
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Provider Business Mailing Address
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Address Line | PO BOX 190
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City | TOPPENISH
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State | WA
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Zip | 98948-0190
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Country | US
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Telephone | 509-865-5600
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Fax | 509-865-5783
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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 | 60970209
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License Number State | WA
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