Provider Demographics
NPI:1407956162
Name:CHIANG, ERIC C (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
Last Name:CHIANG
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 1:1273 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-7069
Mailing Address - Country:US
Mailing Address - Phone:909-920-9543
Mailing Address - Fax:909-949-8013
Practice Address - Street 1:1273 W 7TH ST
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-7069
Practice Address - Country:US
Practice Address - Phone:909-920-9543
Practice Address - Fax:909-949-8013
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA392451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice