Duc Tang Dds Pllc | |
10844 Providence Rd Ste 270 Charlotte NC 28277-3596 | |
(704) 321-0980 | |
Not Available |
Full Name | Duc Tang Dds Pllc |
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Speciality | Dentist |
Location | 10844 Providence Rd, Charlotte, North Carolina |
Authorized Official Name and Position | Duc Tang (OWNER) |
Authorized Official Contact | 7043210980 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Duc Tang Dds Pllc 10844 Providence Rd Ste 270 Charlotte NC 28277-3596 Ph: (704) 321-0980 | Duc Tang Dds Pllc 10844 Providence Rd Ste 270 Charlotte NC 28277-3596 Ph: (704) 321-0980 |
NPI Number | 1295188480 |
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Provider Enumeration Date | 07/22/2016 |
Last Update Date | 07/12/2022 |
Medicare PECOS PAC ID | 7113208059 |
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Medicare Enrollment ID | O20220729000369 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295188480 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
Provider Name | Duc Tang |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1720281470 PECOS PAC ID: 8022399963 Enrollment ID: I20220729000417 |
Provider Name | Christopher Phelps |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1396828380 PECOS PAC ID: 1254624810 Enrollment ID: I20220809001910 |
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