Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH010816 | GA |
NPI | 1013208883 |
---|---|
Provider Name | Miss Angeline Chiang |
First Address | Apo, AE 09034-0078 |
Second Address | Atlanta, GA 30312-2848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2011 |
Last Update Date | 27/04/2011 |