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General NPI Number Information
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NPI Number | 1407978976
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Entity Type | Individual
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Provider Name | DOROTHY TZE YAN PANG D.D.S.,M.S.
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Gender | Female
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 823 TARAVAL ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-2428
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Country | US
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Telephone | 415-661-8383
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Fax | 415-661-8330
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Provider Business Mailing Address
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Address Line | 460 GOLD MINE DR
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City | SAN FRANCISCO
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State | CA
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Zip | 94131-2528
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Country | US
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Telephone | 415-826-6697
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Fax | 415-826-6697
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 39996
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License Number State | CA
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