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General NPI Number Information
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NPI Number | 1154784395
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Entity Type | Organization
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Legal Business Name | PETER K. PANG D.D.S., P.A.
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Dates
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Enumeration Date | 04/04/2016
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Last Update Date | 04/04/2016
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Provider Practice Location Address
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Address Line | 10A YORKSHIRE ST SUITE #B
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City | ASHEVILLE
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State | NC
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Zip | 28803-2758
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Country | US
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Telephone | 828-274-3882
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Fax | 828-274-9589
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Provider Business Mailing Address
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Address Line | 10A YORKSHIRE ST SUITE #B
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City | ASHEVILLE
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State | NC
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Zip | 28803-2758
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Country | US
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Telephone | 828-274-3882
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Fax | 828-274-9589
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Authorized Official
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Title or Position | CORPORATE MANAGER
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Name | CAROLINE SWEENEY
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Credential | MBA
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Telephone | 828-274-3882
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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 | 10204
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License Number State | NC
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