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Organization
KEITH S TANG D D S INC
Active
Organization
KEITH S TANG D D S INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH S TANG D.D.S. (CEO)
(949) 252-1889
Entity
Organization
Contact information
Practice address
3785 ALTON PKWY, IRVINE, CA 92606-8293
(949) 252-1889
Mailing address
3785 ALTON PKWY, IRVINE, CA 92606-8293
(949) 252-1889
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40195
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40734964
STATE EMPLOYER NUMBER
CA
Enumeration date
07/27/2006
Last updated
06/16/2016
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