Provider Demographics
NPI:1679759351
Name:DANG, M. MARIE (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:M.
Middle Name:MARIE
Last Name:DANG
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:DR
Other - First Name:MYDZUNG
Other - Middle Name:MARIE
Other - Last Name:DANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD, MS
Mailing Address - Street 1:3100 PRINCETON PIKE
Mailing Address - Street 2:BUILDING 1, SUITE C
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2300
Mailing Address - Country:US
Mailing Address - Phone:609-896-0333
Mailing Address - Fax:609-896-0880
Practice Address - Street 1:3100 PRINCETON PIKE
Practice Address - Street 2:BUILDING 1, SUITE C
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2300
Practice Address - Country:US
Practice Address - Phone:609-896-0333
Practice Address - Fax:609-896-0880
Is Sole Proprietor?:No
Enumeration Date:2008-01-13
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI021147001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics