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General NPI Number Information
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NPI Number | 1083337356
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Entity Type | Organization
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Legal Business Name | TAN NGO DDS PLLC
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Dates
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Enumeration Date | 09/22/2022
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 6520 FM 359 SOUTH SUITE 200
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City | FULSHEAR
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State | TX
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Zip | 77441
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Country | US
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Telephone | 832-789-1455
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Fax |
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Provider Business Mailing Address
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Address Line | 6520 FM 359 SOUTH SUITE 200 SUITE 200
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City | FULSHEAR
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State | TX
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Zip | 77441
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Country | US
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Telephone | 832-789-1455
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Fax | 832-789-1456
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Authorized Official
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Title or Position | MANAGER
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Name | TAN NGO
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Credential | DDS
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Telephone | 832-789-1455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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