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General NPI Number Information
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NPI Number | 1134867815
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Entity Type | Organization
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Legal Business Name | DANIEL W. JIANG, DMD, PC
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Dates
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Enumeration Date | 05/23/2022
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 84 HIGH ST STE 204
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City | MEDFORD
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State | MA
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Zip | 02155-3844
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Country | US
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Telephone | 781-395-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 84 HIGH ST STE 204
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City | MEDFORD
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State | MA
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Zip | 02155-3844
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL JIANG
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Credential | DMD
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Telephone | 617-803-1365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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