Provider Demographics
NPI:1235309550
Name:HAN K.TAK,D.D.S. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HAN K.TAK,D.D.S. A PROFESSIONAL CORPORATION
Other - Org Name:DENTAL ARTS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAN
Authorized Official - Middle Name:KYUNG
Authorized Official - Last Name:TAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-440-0160
Mailing Address - Street 1:607 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3201
Mailing Address - Country:US
Mailing Address - Phone:213-624-6482
Mailing Address - Fax:213-624-6483
Practice Address - Street 1:607 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3201
Practice Address - Country:US
Practice Address - Phone:213-624-6482
Practice Address - Fax:213-624-6483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty