Provider Demographics
NPI:1821168543
Name:LANG, JEFFREY NEIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:NEIL
Last Name:LANG
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 1:890 NORTHERN WAY
Mailing Address - Street 2:SUITE G
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-3880
Mailing Address - Country:US
Mailing Address - Phone:407-365-6691
Mailing Address - Fax:407-971-9330
Practice Address - Street 1:890 NORTHERN WAY
Practice Address - Street 2:SUITE G
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-3880
Practice Address - Country:US
Practice Address - Phone:407-365-6691
Practice Address - Fax:407-971-9330
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL79941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice