Provider Demographics
NPI:1578703864
Name:SEUNG M KANG, DDS INC.
Entity Type:Organization
Organization Name:SEUNG M KANG, DDS INC.
Other - Org Name:PREMIER DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEUNG
Authorized Official - Middle Name:M
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-298-7664
Mailing Address - Street 1:15892 PASADENA AVE
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-5415
Mailing Address - Country:US
Mailing Address - Phone:714-573-7100
Mailing Address - Fax:714-505-0101
Practice Address - Street 1:15892 PASADENA AVE
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-5415
Practice Address - Country:US
Practice Address - Phone:714-573-7100
Practice Address - Fax:714-505-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54733261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental