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Provider Information for 1386867679

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. THOMAS T TANG D.D.S.

Gender: MALE

Individual NPI: 1386867679

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1386867679
Enumeration Date 2007-04-11
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 17185 W NORTH AVE
BROOKFIELD, WI 53005-4428
United States

Phone: 262-821-1000 | Fax: 262-821-5004
View Map External Link
Primary Practice Address 17185 W NORTH AVE
BROOKFIELD, WI 53005-4428
United States

Phone: 262-821-1000 | Fax: 262-821-5004
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other STATE LICENSE WI 3801
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice WI 3801