Provider Demographics
NPI:1548348741
Name:PANG, ERIC (DDS)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:PANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6851 AMADOR PLAZA RD
Mailing Address - Street 2:#104B
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2940
Mailing Address - Country:US
Mailing Address - Phone:925-560-9968
Mailing Address - Fax:925-560-9962
Practice Address - Street 1:6851 AMADOR PLAZA RD
Practice Address - Street 2:#104B
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2940
Practice Address - Country:US
Practice Address - Phone:925-560-9968
Practice Address - Fax:925-560-9962
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA462081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice