Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 22DI02565400 | NJ |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 22DI02565400 | NJ |
NPI | 1083953533 |
---|---|
Provider Name | Dr. Tiffany Kuang |
First Address | Fort Lee, NJ 07024-3828 |
Second Address | Maywood, NJ 07607-1452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2013 |
Last Update Date | 07/07/2019 |