Provider Demographics
NPI:1225150543
Name:HUANG, MICHAEL C (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:HUANG
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 1:520 WEST BADILLO STREET
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722
Mailing Address - Country:US
Mailing Address - Phone:626-332-1014
Mailing Address - Fax:626-915-2366
Practice Address - Street 1:520 WEST BADILLO STREET
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722
Practice Address - Country:US
Practice Address - Phone:626-332-1014
Practice Address - Fax:626-915-2366
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA541511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice