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General NPI Number Information
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NPI Number | 1982182101
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Entity Type | Individual
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Provider Name | WON KYUNG YANG
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Gender | Female
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | TORII STATION DENTAL CLINIC
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City | APO
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State | AP
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Zip | 96376
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Country | US
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Telephone | 315-652-4059
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 560 BOX 734
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City | APO
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State | AP
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Zip | 96376-0008
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Country | US
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Telephone |
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS102848
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License Number State | CA
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