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General NPI Number Information
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NPI Number | 1003225558
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Entity Type | Individual
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Provider Name | THOMAS ANTHONY LANGAN JR. D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/20/2016
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Provider Practice Location Address
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Address Line | 8201 HENRY AVE APT P35
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City | PHILADELPHIA
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State | PA
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Zip | 19128-2245
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Country | US
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Telephone | 267-702-5413
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Fax |
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Provider Business Mailing Address
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Address Line | 412 NORTHERN SPY ROAD
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411
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Country | US
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Telephone | 267-702-5413
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DS039522
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DS039522
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License Number State | PA
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