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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