Provider Demographics
NPI:1962935296
Name:ZANG, TRACY A (DDS)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:A
Last Name:ZANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:501 HOLIDAY DR
Mailing Address - Street 2:FOSTER PLAZA FOUR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-2749
Mailing Address - Country:US
Mailing Address - Phone:888-633-6468
Mailing Address - Fax:412-937-8599
Practice Address - Street 1:112 CORRECTIONAL DR.
Practice Address - Street 2:NORTHERN REGIONAL CORRECTIONAL FACILITY
Practice Address - City:MOUNDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26041
Practice Address - Country:US
Practice Address - Phone:304-843-4084
Practice Address - Fax:304-843-4089
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV37381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice