Provider Demographics
NPI:1972797710
Name:DANG, ANTHONY QUANG (DDS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:QUANG
Last Name:DANG
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 1:33240 SUNRIVER CMN
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-1568
Mailing Address - Country:US
Mailing Address - Phone:510-386-7185
Mailing Address - Fax:
Practice Address - Street 1:33240 SUNRIVER CMN
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94555-1568
Practice Address - Country:US
Practice Address - Phone:510-386-7185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56211122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist