Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN1857397 | MA |
NPI | 1003361502 |
---|---|
Provider Name | Ping Zhang |
First Address | Worcester, MA 01603-1450 |
Second Address | Worcester, MA 01603-1450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2016 |
Last Update Date | 25/08/2016 |