Individual
DR. MICHAEL KANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
509 OLIVE WAY, SUITE 1633, SEATTLE, WA 98101
(206) 624-8313
(206) 624-8922
Mailing address
509 OLIVE WAY, SUITE 1633, SEATTLE, WA 98101
(206) 624-8313
(206) 624-8922
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN1856135
MA
1223E0200X
Endodontics
Primary
DE60567455
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE60567455
WA STATE DENTAL LICENSE
WA
01
—
DN1856135
DENTAL LICENSURE
MA
Enumeration date
09/07/2012
Last updated
11/09/2016
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