Individual
RUSSELL TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3750 W GREENWAY RD, PHOENIX, AZ 85053-3703
(602) 223-1832
Mailing address
1575 33RD AVE, SAN FRANCISCO, CA 94122-3144
(415) 876-8049
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D011889
AZ
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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