Individual
DR. GINN L FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 562-4891
Mailing address
462 1ST AVE, NEW YORK, NY 10016-9196
(212) 562-4891
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
061497
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2019
Last updated
06/06/2022
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