Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 9220 | TN |
N | 1223D0001X | Dental Public Health | 25022 | TX |
NPI | 1649572611 |
---|---|
Provider Name | Dr. Liang Hong |
First Address | Memphis, TN 38103-3513 |
Second Address | Memphis, TN 38103-3513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2010 |
Last Update Date | 24/11/2010 |