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Organization

CHILDRENS DENTAL CARE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHEN DER J CHIANG DDS (OFFICE OWNER PEDIATRIC DENTIST)
(626) 369-1177
Entity
Organization

Contact information

Practice address
2219 S HACIENDA BLVD, 100, HACIENDA HEIGHTS, CA 91745
(626) 369-1177
(626) 369-1186
Mailing address
2219 S HACIENDA BLVD, 100, HACIENDA HEIGHTS, CA 91745
(626) 369-1177
(626) 369-1186

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
B38660
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
B3866001
CA
Enumeration date
09/10/2007
Last updated
09/10/2007
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