MEDICARE: ANGELA T. HUANG DENTAL CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	50470	CA

General Provider Information

NPI Number	:	1619138831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELA T. HUANG DENTAL CORP

Provider Business Mailing Address
First Line	:	17522 HAWTHORNE BLVD
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90504-3110
Country	:	US
Telephone Number	:	310-793-8899
Fax Number	:	310-793-8815

Provider Business Practice Location Address
First Line	:	17522 HAWTHORNE BLVD
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90504-3110
Country	:	US
Telephone Number	:	310-793-8899
Fax Number	:	310-793-8815

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANGELA T HUANG
Credential	:	D.M.D.
Telephone Number	:	310-793-8899

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	10/31/2012

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