Organization
TIMOTHY C. LANG, DDS, MD, PA
Active
Organization
TIMOTHY C. LANG, DDS, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY CORRIGAN LANG DDS, MD (CEO)
(321) 777-2166
Entity
Organization
Contact information
Practice address
2030 S PATRICK DR, SUITE 1, INDIAN HARBOUR BEACH, FL 32937-4400
(321) 777-2166
(321) 777-2191
Mailing address
2030 S PATRICK DR, SUITE 1, INDIAN HARBOUR BEACH, FL 32937-4400
(321) 777-2166
(321) 777-2191
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
ME0068501
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253999300
—
FL
01
—
27225
BLUE CROSS BLUE SHIELD
FL
01
—
791334
UNITED CONCORDIA ID
—
01
—
995474
COMPBENEFITS FACILITY NUM
FL
Enumeration date
05/15/2007
Last updated
04/13/2016
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