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General NPI Number Information
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NPI Number | 1003019845
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Entity Type | Individual
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Provider Name | DANA THI TANG DDS
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Gender | Female
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 11/09/2016
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Provider Practice Location Address
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Address Line | 2997 HOPE MILLS RD STE C
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-8349
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Country | US
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Telephone | 910-426-0800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 860036
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City | MINNEAPOLIS
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State | MN
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Zip | 55486-0036
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Country | US
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Telephone | 910-426-0800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 30175
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 8404
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License Number State | NC
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