Individual ProviderTanguy CanongeStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice AddressOne Kneeland Street, 11th Floor (Orthodontics), Tufts University School Of Dental Medicine, Boston, MA 02111(617) 636-3471PECOS EnrollmentBased on the most recent information from CMS, provider Tanguy Canonge does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1144604810Provider TypeIndividualFull NameCanonge, TanguyTitleMr.CredentialDDSGenderMaleSole ProprietorNoEnumeration Date7/13/2015Last Updated3/22/2016Contact InformationPractice LocationPractice AddressOne Kneeland Street, 11th Floor (Orthodontics), Tufts University School Of Dental Medicine, Boston, MA 02111Phone(617) 636-3471FaxUnlisted FaxMailing LocationMailing AddressOne Kneeland Street, 11th Floor (Orthodontics), Tufts University School Of Dental Medicine, Boston, MA 02111Phone(617) 636-3471FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer