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Organization
KANG, HYO S. DMD INC.
Active
Organization
KANG, HYO S. DMD INC.
Active
Other names
Wellspring Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HYO S KANG DMD (PRESIDENT)
(925) 336-9611
Entity
Organization
Contact information
Practice address
1700 PENNSYLVANIA AVE, SUITE D, FAIRFIELD, CA 94533-3588
(925) 336-9611
Mailing address
8051 BRIAR OAKS DR, SAN RAMON, CA 94582-5196
(925) 336-9611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
56041
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972793651
NATIONAL NPI
CA
Enumeration date
06/01/2016
Last updated
06/01/2016
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