Individual
KEVIN BANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
455 HICKEY BLVD STE 403, DALY CITY, CA 94015-2630
(917) 699-2815
Mailing address
2520 CARLMONT DR APT 9, BELMONT, CA 94002-3243
(917) 699-2815
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
056677
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
104
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
A135925
CA
Other
Enumeration date
10/29/2007
Last updated
11/30/2017
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