Provider Demographics
NPI:1699173864
Name:DUONG AND DANG DENTAL CORPORATION
Entity type:Organization
Organization Name:DUONG AND DANG DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:MAURNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-281-7493
Mailing Address - Street 1:2735 DEL PASO RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2311
Mailing Address - Country:US
Mailing Address - Phone:916-263-9724
Mailing Address - Fax:
Practice Address - Street 1:2735 DEL PASO RD STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-2311
Practice Address - Country:US
Practice Address - Phone:916-263-9724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA472521223G0001X
CA470661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty