Organization
PROSPECT DENTAL GROUP, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE KYUNGMOOK KHANG DMD (OWNER)
(617) 576-5300
Entity
Organization
Contact information
Practice address
30 PROSPECT ST., CAMBRIDGE, MA 02139
(617) 576-5300
(617) 576-5500
Mailing address
30 PROSPECT ST., CAMBRIDGE, MA 02139
(617) 576-5300
(617) 576-5500
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
21214
MA
Other
Enumeration date
02/23/2009
Last updated
07/10/2012
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