Provider Demographics
NPI:1780674739
Name:DONG, ANGELA Q (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:Q
Last Name:DONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:596 COLUMBIA TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-1617
Mailing Address - Country:US
Mailing Address - Phone:518-477-7373
Mailing Address - Fax:518-477-7638
Practice Address - Street 1:596 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-1617
Practice Address - Country:US
Practice Address - Phone:518-477-7373
Practice Address - Fax:518-477-7638
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0477181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice