Individual
DR. CALEB KYUNGSUP JANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
956 CHANDLER CT, WALDORF, MD 20602-2800
(301) 705-9737
Mailing address
4802 NASH DR, FAIRFAX, VA 22032-2530
(917) 575-5127
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401416443
VA
1223G0001X
General Practice Dentistry
Primary
17227
MD
1223G0001X
General Practice Dentistry
DEN1001883
DC
Other
Enumeration date
05/08/2018
Last updated
11/07/2020
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