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General NPI Number Information
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NPI Number | 1932316411
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Entity Type | Organization
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Legal Business Name | JAMES FANG, D.D.S., INC.
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 2096 W. LA HABRA BLVD
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City | LA HABRA
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State | CA
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Zip | 90631-5007
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Country | US
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Telephone | 562-905-1828
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Fax |
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Provider Business Mailing Address
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Address Line | 2096 W. LA HABRA BLVD
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City | LA HABRA
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State | CA
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Zip | 90631-5007
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Country | US
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Telephone | 562-905-1828
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Fax |
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Authorized Official
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Title or Position | CORPORATE SECRETARY,DENTIST
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Name | DR. JURIE DU FANG
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Credential | D.D.S.
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Telephone | 562-905-1828
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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 | 41074
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License Number State | CA
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