Provider Demographics
NPI:1073922951
Name:PANG, SEOKJOON (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEOKJOON
Middle Name:
Last Name:PANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2576 OAK RD APT 206
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597
Mailing Address - Country:US
Mailing Address - Phone:925-899-7339
Mailing Address - Fax:
Practice Address - Street 1:3587 SONOMA BLVD
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-2945
Practice Address - Country:US
Practice Address - Phone:707-561-9213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist