MEDICARE: LUER WANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D012208	AZ
2	390200000X	Student in an Organized Health Care Education/Training Program
3	1223G0001X	General Practice Dentistry	13919	NC

General Provider Information

NPI Number	:	1184477556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUER WANG

Provider Business Mailing Address
First Line	:	160 TUNNEL RD
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28805-1853
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 TUNNEL RD
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28805-1853
Country	:	US
Telephone Number	:	828-333-6179
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2024
Last Update Date	:	09/25/2024

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Directions to “ LUER WANG ” Practice Location

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