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General NPI Number Information
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NPI Number | 1427291830
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Entity Type | Individual
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Provider Name | TENILLE N PHANG D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 2444 E SEMORAN BLVD
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City | APOPKA
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State | FL
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Zip | 32703-5805
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Country | US
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Telephone | 407-410-6848
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Fax | 407-775-2561
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Provider Business Mailing Address
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Address Line | 2444 E SEMORAN BLVD
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City | APOPKA
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State | FL
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Zip | 32703-5805
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Country | US
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Telephone | 516-884-8590
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN24517
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License Number State | FL
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