Provider Demographics
NPI:1083019970
Name:TRIANGLE DENTAL ASSOCIATE
Entity Type:Organization
Organization Name:TRIANGLE DENTAL ASSOCIATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:WEIDONG
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:410-398-7711
Mailing Address - Street 1:230 S BRIDGE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5915
Mailing Address - Country:US
Mailing Address - Phone:410-398-7711
Mailing Address - Fax:410-398-7999
Practice Address - Street 1:230 S BRIDGE ST
Practice Address - Street 2:SUITE A
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5915
Practice Address - Country:US
Practice Address - Phone:410-398-7711
Practice Address - Fax:410-398-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental