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Organization
EUN SUB JANG, D.D.S. INC
Active
Organization
EUN SUB JANG, D.D.S. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUN SUB JANG D.D.S. (DENTIST)
(707) 545-3368
Entity
Organization
Contact information
Practice address
95 MONTGOMERY DR, # 218, SANTA ROSA, CA 95404-6630
(707) 545-3368
Mailing address
95 MONTGOMERY DR, # 218, SANTA ROSA, CA 95404-6630
(707) 545-3368
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
48468
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48468
STATE LICENSE NUMBER
CA
Enumeration date
05/29/2007
Last updated
08/22/2020
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