| NPI | 1134662828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DUK GEN CHANG President 408-736-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 61014) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 100295) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: CA 61238) | |
| 1223P0221X Dentist Pediatric Dentistry (Licence: CA 62413) | |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-11-29 |