Provider Demographics
NPI:1649796038
Name:CHAN & HUANG DENTAL PARTNERSHIP
Entity type:Organization
Organization Name:CHAN & HUANG DENTAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISSAC
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-373-3200
Mailing Address - Street 1:3640 LOMITA BLVD., #208
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505
Mailing Address - Country:US
Mailing Address - Phone:310-373-3200
Mailing Address - Fax:310-378-7328
Practice Address - Street 1:3640 LOMITA BLVD., #208
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505
Practice Address - Country:US
Practice Address - Phone:310-373-3200
Practice Address - Fax:310-378-7328
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHAN & HUANG DENTAL PARTNERSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA615731223G0001X
CA314751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty