Provider Demographics
NPI:1891952289
Name:KANG, YOON H (DMD, PHD)
Entity Type:Individual
Prefix:DR
First Name:YOON
Middle Name:H
Last Name:KANG
Suffix:
Gender:M
Credentials:DMD, PHD
Other - Prefix:DR
Other - First Name:YOON
Other - Middle Name:'HENRY'
Other - Last Name:KANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD, PHD
Mailing Address - Street 1:25 SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1721
Mailing Address - Country:US
Mailing Address - Phone:508-652-8087
Mailing Address - Fax:508-319-3090
Practice Address - Street 1:93 UNION ST
Practice Address - Street 2:SUITE 404
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-2244
Practice Address - Country:US
Practice Address - Phone:617-244-8087
Practice Address - Fax:508-319-3090
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60078827122300000X
MA221331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist