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General NPI Number Information
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NPI Number | 1922670678
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Entity Type | Individual
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Provider Name | DAQIU REN DMD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 123 N 13TH ST
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City | ALLENTOWN
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State | PA
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Zip | 18102-3758
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Country | US
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Telephone | 610-572-1896
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Fax |
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Provider Business Mailing Address
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Address Line | 1345 MARTIN CT APT 933
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City | BETHLEHEM
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State | PA
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Zip | 18018-2584
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Country | US
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Telephone | 267-593-4513
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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 | DS043223
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License Number State | PA
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