Individual
MR. CLARENCE SPENCER TANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
13422 POMERADO RD STE 201, POWAY, CA 92064-3548
(847) 769-5381
Mailing address
10229 PRAIRIE SPRINGS RD, SAN DIEGO, CA 92127-3421
(847) 769-5381
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
019.030300
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
109682
CA
Other
Enumeration date
06/01/2007
Last updated
11/30/2023
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