Individual
MR. PAUL CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3003 HIGHWAY 95, SUITE B-33, BULLHEAD CITY, AZ 86442-7860
(928) 763-8750
(928) 763-8801
Mailing address
P.O. BOX 30060, LAUGHLIN, NV 89028-0192
(928) 234-3078
(928) 763-8801
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5774
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
898380
—
AZ
05
—
A05774
—
CA
Enumeration date
05/18/2006
Last updated
05/18/2010
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