Provider Demographics
NPI:1407139553
Name:HUANG, PRESTON JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:PRESTON
Middle Name:JAMES
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 1:10 EAST STATE ST
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043
Mailing Address - Country:US
Mailing Address - Phone:801-766-3700
Mailing Address - Fax:801-331-8210
Practice Address - Street 1:10 EAST STATE ST
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043
Practice Address - Country:US
Practice Address - Phone:801-766-3700
Practice Address - Fax:801-331-8210
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8058592-99221223G0001X
CA605901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice