Organization
HIRANO KANUGA DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHUKAN KANUGA DDS, MSD (PARTNER)
(310) 463-5027
Entity
Organization
Contact information
Practice address
18580 VIA PRINCESSA STE 3, CANYON COUNTRY, CA 91387-8329
(661) 388-0499
Mailing address
18580 VIA PRINCESSA STE 3, CANYON COUNTRY, CA 91387-8329
(661) 388-0499
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
57764
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790975597
—
CA
Enumeration date
04/24/2018
Last updated
04/24/2018
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