Most Relevant Information
Provider Data
| NPI Number: | 1003395922 |
| Provider Name: | MADELEINE WAN YONG TAN BDSC, MDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | DL13729 |
Most Important Dates
| Enumeration Date: | 08/10/2018 |
| Last Updated: | 08/10/2018 |
Provider Practice Location
1200 CENTRE ST
ROSLINDALE
MA
021311000
Practice Location Phone/Fax
| Phone: | 6173782326 |
| Fax: |
Provider Mailing Location
143 PARK DR APT 43
BOSTON
MA
022155160
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |