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General NPI Number Information
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NPI Number | 1962804195
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Entity Type | Organization
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Legal Business Name | K. KANG, J. LEE & P. KANG DDS INC
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 6742 GREENLEAF AVE STE 300
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City | WHITTIER
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State | CA
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Zip | 90601-5154
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Country | US
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Telephone | 562-945-1684
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Fax |
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Provider Business Mailing Address
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Address Line | 6742 GREENLEAF AVE STE 300
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City | WHITTIER
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State | CA
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Zip | 90601-5154
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Country | US
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Telephone | 562-945-1684
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. JENNIFER C LEE
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Credential | D.D.S.
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Telephone | 562-945-1684
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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 | 51963
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License Number State | CA
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