Provider Demographics
NPI:1841537552
Name:YAT YEUNG TANG, DDS, INC.
Entity type:Organization
Organization Name:YAT YEUNG TANG, DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:YAT
Authorized Official - Middle Name:Y
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-925-3717
Mailing Address - Street 1:2050 S BROADWAY
Mailing Address - Street 2:SUITE E
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-8801
Mailing Address - Country:US
Mailing Address - Phone:805-925-3717
Mailing Address - Fax:805-925-3732
Practice Address - Street 1:1414 S MILLER ST
Practice Address - Street 2:SUITE #1
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6923
Practice Address - Country:US
Practice Address - Phone:805-349-8890
Practice Address - Fax:805-349-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA565011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty