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General NPI Number Information
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NPI Number | 1366052482
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Entity Type | Individual
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Provider Name | TONY KAILI ZHANG DDS
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Gender | Male
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 110 OPPORTUNITY BLVD S STE A
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City | CAMBRIDGE
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State | MN
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Zip | 55008-2222
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Country | US
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Telephone | 716-331-0120
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Fax |
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Provider Business Mailing Address
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Address Line | 11670 GOODHUE ST NE
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City | BLAINE
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State | MN
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Zip | 55449-4653
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Country | US
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Telephone | 281-818-0926
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 36240
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License Number State | TX
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