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General NPI Number Information
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NPI Number | 1881775047
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Entity Type | Individual
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Provider Name | JUDITH QIONG YANG D.M.D., M.S.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CMR 402 LANDSTUHL DENTAL ACTIVITY CREDENTIALS OFFICE
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City | APO AE
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State | NY
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Zip | 09180
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Country | US
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Telephone | 631-536-8125
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Fax |
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Provider Business Mailing Address
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Address Line | CMR 402 LANDSTUHL DENTAL ACTIVITY CREDENTIALS OFFICE
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City | APO AE
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State | NY
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Zip | 09180
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Country | US
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Telephone | 631-536-8125
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 047923
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License Number State | NY
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