Individual
MS. LAN-TU DANG HOLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
(573) 582-1212
Mailing address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
(573) 582-1212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
014975
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902892235
NATIONAL PROVIDER IDENTIF
MO
05
—
403030430
—
MO
Enumeration date
09/22/2005
Last updated
03/10/2020
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