Healthcare Provider Details

I. General information

NPI: 1164735585
Provider Name (Legal Business Name): YING WAI SIA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 06/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4295 ANDRE LAURENDEAU APT 4
MONTREAL QUEBEC
H1Y 3R6
CA

IV. Provider business mailing address

4295 ANDRE LAURENDEAU APT 4
MONTREAL QUEBEC
H1Y 3R6
CA

V. Phone/Fax

Practice location:
  • Phone: 514-569-8177
  • Fax:
Mailing address:
  • Phone: 514-569-8177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: