Most Relevant Information
Provider Data
| NPI Number: | 1003496316 |
| Provider Name: | CHUNWOO KANG DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | TD-00-137 |
Most Important Dates
| Enumeration Date: | 04/11/2021 |
| Last Updated: | 05/11/2022 |
Provider Practice Location
1801 CAMINO DE SALUD NE
ALBUQUERQUE
NM
871024516
Practice Location Phone/Fax
| Phone: | 5059254031 |
| Fax: |
Provider Mailing Location
8415 CHATEAU DR NE
ALBUQUERQUE
NM
871224204
Provider Mailing Phone/Fax
| Phone: | 5052388632 |
| Fax: |