Individual
TAE HYUNG KANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8400 NE VANCOUVER MALL LOOP, VANCOUVER, WA 98662-6671
(360) 450-6639
Mailing address
14954 NW OLIVE ST, PORTLAND, OR 97229-7020
(503) 901-3558
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
60760032
WA
122300000X
Dentist
Primary
D10675
OR
Other
Enumeration date
07/19/2017
Last updated
08/07/2020
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