Provider Demographics
NPI:1295188480
Name:DUC TANG DDS PLLC
Entity Type:Organization
Organization Name:DUC TANG DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUC
Authorized Official - Middle Name:
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-321-0980
Mailing Address - Street 1:10844 PROVIDENCE RD
Mailing Address - Street 2:STE 270
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3596
Mailing Address - Country:US
Mailing Address - Phone:704-321-0980
Mailing Address - Fax:
Practice Address - Street 1:10844 PROVIDENCE RD
Practice Address - Street 2:STE 270
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-3596
Practice Address - Country:US
Practice Address - Phone:704-321-0980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty