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NPI Code Detail

MEDICARE: MS. STEFANIE A WONG D.D.S.

MEDICARE:  MS. STEFANIE A WONG  D.D.S.
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
11223G0001XGeneral Practice Dentistry0401411828VA

General Provider Information

NPI Number : 1437340452
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEFANIE A WONG D.D.S.
Provider Business Mailing Address
First Line : 3156 MAGIC HOLLOW BLVD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23453-3011
Country : US
Telephone Number : 757-468-4867
Fax Number : 757-368-0797
Provider Business Practice Location Address
First Line : 3156 MAGIC HOLLOW BLVD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23453-3011
Country : US
Telephone Number : 757-468-4867
Fax Number : 757-368-0797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2007
Last Update Date : 08/06/2007

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Directions to “ MS. STEFANIE A WONG D.D.S.” Practice Location

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