| Organization Name: | ANDY CHANG DDS A DENTAL CORPORATION |
| NPI Number: | 1033307202 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDY HAN CHANG (PRESIDENT) |
| Mailing Address: | 825 W Duarte Rd Apt A Monrovia |
| State: | CA US |
| Postal Code: | 910167500 |
| Phone Number: | 6267106797 |
| Fax Number: | |
| NPI Enumeration Date: | 10/11/2007 |
| NPI Last Update Date: | 10/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 52351 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |