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Organization
PHILIP CHANG DDS DENTAL CORPORATION
Active
Organization
PHILIP CHANG DDS DENTAL CORPORATION
Active
Other names
Create Smiles Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP MINSUK CHANG DDS (CEO)
(424) 731-7096
Entity
Organization
Contact information
Practice address
1611 CRENSHAW BLVD STE C, TORRANCE, CA 90501-7124
(310) 791-7108
(310) 791-7142
Mailing address
1611 CRENSHAW BLVD STE C, TORRANCE, CA 90501-7124
(424) 731-7096
(424) 731-7042
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51048
GENERAL
CA
Enumeration date
01/13/2020
Last updated
09/23/2020
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