Individual
DR. THOMAS T TANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
17185 W NORTH AVE, BROOKFIELD, WI 53005-4428
(262) 821-1000
(262) 821-5004
Mailing address
17185 W NORTH AVE, BROOKFIELD, WI 53005-4428
(262) 821-1000
(262) 821-5004
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3801
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3801
STATE LICENSE
WI
Enumeration date
04/11/2007
Last updated
07/08/2007
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