Provider Demographics
NPI:1942427612
Name:KANG, PILGOO (DDS)
Entity Type:Individual
Prefix:DR
First Name:PILGOO
Middle Name:
Last Name:KANG
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 1:185 BRIDGE PLZ N
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5907
Mailing Address - Country:US
Mailing Address - Phone:201-363-1033
Mailing Address - Fax:
Practice Address - Street 1:185 BRIDGE PLZ N
Practice Address - Street 2:SUITE 2
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5907
Practice Address - Country:US
Practice Address - Phone:201-363-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 205761223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics