Provider Demographics
NPI:1952028490
Name:DAN B. ANG DDS, LLC
Entity Type:Organization
Organization Name:DAN B. ANG DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:BECK
Authorized Official - Last Name:ANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:763-542-8723
Mailing Address - Street 1:5851 DULUTH STREET
Mailing Address - Street 2:SUITE 313
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-3957
Mailing Address - Country:US
Mailing Address - Phone:763-542-8723
Mailing Address - Fax:763-512-1942
Practice Address - Street 1:5851 DULUTH STREET
Practice Address - Street 2:SUITE 313
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-3957
Practice Address - Country:US
Practice Address - Phone:763-542-8723
Practice Address - Fax:763-512-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty