Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | P8484 | TX |
Y | 2086X0206X | Surgical Oncologist | P8484 | TX |
NPI | 1073601951 |
---|---|
Provider Name | David Kang |
First Address | Dallas, TX 75203-1259 |
Second Address | Dallas, TX 75203-1259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 26/06/2016 |