Provider Demographics
NPI:1043565864
Name:PANG, YIU CHUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:YIU CHUNG
Middle Name:
Last Name:PANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 159TH ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1816
Mailing Address - Country:US
Mailing Address - Phone:718-362-7978
Mailing Address - Fax:
Practice Address - Street 1:6111 159TH ST APT 2A
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-1816
Practice Address - Country:US
Practice Address - Phone:718-362-7978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program