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NPI Code Detail

MEDICARE: THUONG T DANG DDS, A PROFESSIONAL CORP

MEDICARE: THUONG T DANG DDS, A PROFESSIONAL CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry5696NV

General Provider Information

NPI Number : 1235688037
Entity Type Code : Organization
Provider Name (Legal Business Name) : THUONG T DANG DDS, A PROFESSIONAL CORP
Provider Business Mailing Address
First Line : 6116 W FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-2280
Country : US
Telephone Number : 702-369-5551
Fax Number :
Provider Business Practice Location Address
First Line : 6116 W FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-2280
Country : US
Telephone Number : 702-369-5551
Fax Number :
Authorized Official
Title or Position : DENTIST/ PRESIDENT
Name : DR. THUONG TRAN DANG
Credential : DDS
Telephone Number : 702-369-5551
Provider Enumeration Date : 09/22/2016
Last Update Date : 09/22/2016

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Directions to “THUONG T DANG DDS, A PROFESSIONAL CORP ” Practice Location

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