# BROOKDALE DENTAL CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kong Vang DMD,PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831392844
- **Authorized official:** DR. KONG VANG DMD (DENTIST)
- **Authorized official phone:** (704) 597-7772

## Contact information

- **Practice address:** 9621 BROOKDALE DR STE 200, CHARLOTTE, NC 28215-8786
- **Practice address phone:** (704) 597-7772
- **Practice address fax:** (704) 597-7078
- **Mailing address:** 9621 BROOKDALE DR STE 200, CHARLOTTE, NC 28215-8786
- **Mailing address phone:** (704) 597-7772
- **Mailing address fax:** (704) 597-7078

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7388 | NC | Yes |

## Other

- **Enumeration date:** 06/07/2007
- **Last updated:** 04/09/2008