Provider Demographics
NPI:1710178884
Name:DR. ZHANG'S DENTAL OFFICE
Entity Type:Organization
Organization Name:DR. ZHANG'S DENTAL OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:XUGUANG
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-471-8979
Mailing Address - Street 1:2503 E LAKESHORE DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4433
Mailing Address - Country:US
Mailing Address - Phone:951-471-8979
Mailing Address - Fax:951-471-3969
Practice Address - Street 1:2503 E LAKESHORE DR
Practice Address - Street 2:SUITE E
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-4433
Practice Address - Country:US
Practice Address - Phone:951-471-8979
Practice Address - Fax:951-471-3969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50027122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty