Individual
DR. TAE HO KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5201 WASHINGTON AVE STE A, MOUNT PLEASANT, WI 53406-4242
(888) 988-4066
Mailing address
2050 E ALGONQUIN RD, SUITE 610, SCHAUMBURG, IL 60173-4144
(888) 988-4066
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001434
WI
1223G0001X
General Practice Dentistry
31576
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2015
Last updated
11/23/2016
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