Individual
ANNIE DANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 LA RICA AVE STE D, BALDWIN PARK, CA 91706-3163
(626) 598-8484
Mailing address
813 N LANGHAM AVE, COVINA, CA 91724-2522
(626) 927-7640
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
75440
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75440
—
CA
Enumeration date
04/26/2019
Last updated
04/26/2019
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