Provider Demographics
NPI:1831269828
Name:SY TANGCO, LYNE TAN (DDS)
Entity type:Individual
Prefix:DR
First Name:LYNE
Middle Name:TAN
Last Name:SY TANGCO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LYNE
Other - Middle Name:
Other - Last Name:SY TANGCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1706 E SEMORAN BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-5651
Mailing Address - Country:US
Mailing Address - Phone:407-886-8817
Mailing Address - Fax:407-886-6625
Practice Address - Street 1:1706 E SEMORAN BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5651
Practice Address - Country:US
Practice Address - Phone:407-886-8817
Practice Address - Fax:407-886-6625
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13935122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist