Provider Demographics
NPI:1447641139
Name:MINSOEK KANG DENTISTRY, PLLC
Entity type:Organization
Organization Name:MINSOEK KANG DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MINSEOK
Authorized Official - Middle Name:
Authorized Official - Last Name:KANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:623-466-6322
Mailing Address - Street 1:15033 W BELL RD
Mailing Address - Street 2:STE 175
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3217
Mailing Address - Country:US
Mailing Address - Phone:623-466-6322
Mailing Address - Fax:623-466-6523
Practice Address - Street 1:15033 W BELL RD
Practice Address - Street 2:STE 175
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3217
Practice Address - Country:US
Practice Address - Phone:623-466-6322
Practice Address - Fax:623-466-6523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ86831223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0004XDental ProvidersDentistDental AnesthesiologyGroup - Single Specialty