Provider Demographics
NPI:1972775062
Name:KANG & LIU DENTISTRY APO
Entity Type:Organization
Organization Name:KANG & LIU DENTISTRY APO
Other - Org Name:GARFIELD DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-288-1688
Mailing Address - Street 1:328 N. GARFIELD AVE
Mailing Address - Street 2:#A & B
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754
Mailing Address - Country:US
Mailing Address - Phone:626-288-1688
Mailing Address - Fax:626-872-0650
Practice Address - Street 1:328 N. GARFIELD AVE
Practice Address - Street 2:SUITE #A & B
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754
Practice Address - Country:US
Practice Address - Phone:626-288-1688
Practice Address - Fax:626-872-0650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD8978501122300000X
CA519451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty