Provider Demographics
NPI:1881874980
Name:K. C. HWANG, DDS, INC
Entity type:Organization
Organization Name:K. C. HWANG, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-445-1431
Mailing Address - Street 1:638 W DUARTE RD
Mailing Address - Street 2:STE 3
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:638 W DUARTE RD
Practice Address - Street 2:STE 3
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7616
Practice Address - Country:US
Practice Address - Phone:626-445-1431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45576261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental