Provider Demographics
NPI:1033205000
Name:LANG, ROGER K (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:K
Last Name:LANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3031 W MARCH LN
Mailing Address - Street 2:SUITE 318E
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-6500
Mailing Address - Country:US
Mailing Address - Phone:209-956-0601
Mailing Address - Fax:209-952-8845
Practice Address - Street 1:3031 W MARCH LN
Practice Address - Street 2:SUITE 318E
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-6500
Practice Address - Country:US
Practice Address - Phone:209-956-0601
Practice Address - Fax:209-952-8845
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA240341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice