Provider Demographics
NPI:1558599092
Name:DANG, CALIE NGA (DMD)
Entity Type:Individual
Prefix:
First Name:CALIE
Middle Name:NGA
Last Name:DANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:MILL HALL
Mailing Address - State:PA
Mailing Address - Zip Code:17751-1829
Mailing Address - Country:US
Mailing Address - Phone:570-726-4988
Mailing Address - Fax:
Practice Address - Street 1:236 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:MILL HALL
Practice Address - State:PA
Practice Address - Zip Code:17751-1829
Practice Address - Country:US
Practice Address - Phone:570-726-4988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037933122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist