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Individual

DR. BRICE CHANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
350 PACIFIC AVE STE 101, BROOKINGS, OR 97415-0241
(541) 469-0192
(360) 892-8902
Mailing address
350 PACIFIC AVE, P.O. BOX 4370, BROOKINGS, OR 97415
(541) 469-0192
(541) 459-5192

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8019
OR
1223G0001X
General Practice Dentistry
D00009300
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5044482
WA
Enumeration date
11/01/2006
Last updated
04/07/2021
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