Organization Name: | TRIANGLE DENTAL ASSOCIATE |
NPI Number: | 1083019970 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WEIDONG YANG (DENTIST) |
Mailing Address: | 230 S Bridge St Suite A Elkton |
State: | MD US |
Postal Code: | 219215915 |
Phone Number: | 4103987711 |
Fax Number: | 4103987999 |
NPI Enumeration Date: | 11/04/2014 |
NPI Last Update Date: | 11/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |