Provider Demographics
NPI:1770879439
Name:DANIEL WONIL HWANG DDS INC
Entity type:Organization
Organization Name:DANIEL WONIL HWANG DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DDS
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:WONIL
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-764-0113
Mailing Address - Street 1:17695 ARROW BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-4041
Mailing Address - Country:US
Mailing Address - Phone:909-356-8074
Mailing Address - Fax:909-356-8084
Practice Address - Street 1:17695 ARROW BLVD STE J
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-4041
Practice Address - Country:US
Practice Address - Phone:909-356-8074
Practice Address - Fax:909-356-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-21
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA470961223G0001X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty