Individual
ROBERT CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
5 PALISADES DR, SUITE 210, ALBANY, NY 12205-6433
(518) 348-0634
(518) 426-3221
Mailing address
5 PALISADES DR, SUITE 210, ALBANY, NY 12205-6433
(518) 348-0634
(518) 426-3221
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
053589
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
247005
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02926121
—
NY
Enumeration date
04/06/2007
Last updated
06/21/2013
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