Organization
SOUTH WINDSOR PERIO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL KANG DDS (OWNER/MANAGER)
(847) 714-6929
Entity
Organization
Contact information
Practice address
469 BUCKLAND RD STE 203, SOUTH WINDSOR, CT 06074-3737
(860) 644-2340
Mailing address
469 BUCKLAND RD STE 203, SOUTH WINDSOR, CT 06074-3737
(860) 644-2340
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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