| NPI | 1881981900 |
|---|---|
| Other Name | KEVIN CHANG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.024067) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH RES3110) |
| Enumeration Date | 2011-07-10 |
| Last Update Date | 2022-05-02 |