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General NPI Number Information
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NPI Number | 1538112685
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Entity Type | Organization
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Legal Business Name | MASSILLON FAMILY CARE INC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 2606 WALES AVE NW SUITE 200
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City | MASSILLON
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State | OH
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Zip | 44646-2340
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Country | US
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Telephone | 330-834-4735
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Fax | 330-834-4736
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Provider Business Mailing Address
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Address Line | 2606 WALES AVE NW SUITE 200
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City | MASSILLON
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State | OH
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Zip | 44646-2340
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Country | US
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Telephone | 330-834-4735
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Fax | 330-834-4736
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SON N DANG
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Credential | MD
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Telephone | 330-834-4735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35071045
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License Number State | OH
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