# TIMOTHY C. LANG, DDS, MD, PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104032275
- **Authorized official:** DR. TIMOTHY CORRIGAN LANG DDS, MD (CEO)
- **Authorized official phone:** (321) 777-2166

## Contact information

- **Practice address:** 2030 S PATRICK DR, SUITE 1, INDIAN HARBOUR BEACH, FL 32937-4400
- **Practice address phone:** (321) 777-2166
- **Practice address fax:** (321) 777-2191
- **Mailing address:** 2030 S PATRICK DR, SUITE 1, INDIAN HARBOUR BEACH, FL 32937-4400
- **Mailing address phone:** (321) 777-2166
- **Mailing address fax:** (321) 777-2191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | ME0068501 | FL | Yes |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 04/13/2016