Provider Demographics
NPI:1265969620
Name:DANG, QUOC (DDS)
Entity type:Individual
Prefix:DR
First Name:QUOC
Middle Name:
Last Name:DANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DYLAN
Other - Middle Name:
Other - Last Name:DANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3260 N ZARAGOZA RD STE D406
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4677
Mailing Address - Country:US
Mailing Address - Phone:915-271-4777
Mailing Address - Fax:
Practice Address - Street 1:3260 N ZARAGOZA RD STE D406
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-4677
Practice Address - Country:US
Practice Address - Phone:915-271-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
TX34827122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No171000000XOther Service ProvidersMilitary Health Care Provider