Organization
MICHAEL CHANG DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL CHANG DDS (PRESIDENT)
(213) 294-1462
Entity
Organization
Contact information
Practice address
142 W BASE LINE RD STE B, RIALTO, CA 92376-3302
(909) 341-5325
Mailing address
1120 S GRAND AVE APT 2612, LOS ANGELES, CA 90015-4659
(213) 294-1462
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/10/2022
Last updated
01/10/2022
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