Individual
DR. TIMOTHY CORRIGAN LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD, PHD
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
DN14085
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
ME0068501
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
791334
UNITED CONCORDIA PROVIDER
—
Enumeration date
09/23/2005
Last updated
07/20/2020
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