Individual
THOMAS Y CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MDS
Contact information
Practice address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
(508) 930-5073
Mailing address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
(508) 559-5073
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17581
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V05568
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/13/2006
Last updated
07/12/2010
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