Individual
JACK CHIANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
840 SE BISHOP BLVD, STE 204, PULLMAN, WA 99163-5502
(509) 332-3213
(509) 332-6262
Mailing address
840 SE BISHOP BLVD, STE 204, PULLMAN, WA 99163-5502
(509) 332-3213
(509) 332-6262
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8759
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019711
—
WA
Enumeration date
10/29/2014
Last updated
10/29/2014
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