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General NPI Number Information
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NPI Number | 1073068649
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Entity Type | Individual
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Provider Name | FENGMING WANG DDS, PHD
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Gender | Male
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 11/03/2016
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Provider Practice Location Address
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Address Line | 3302 GASTON AVE TAMU COLLEGE OF DENTISTRY - ENDODONTICS
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City | DALLAS
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State | TX
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Zip | 75246-2013
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Country | US
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Telephone | 214-828-8362
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Fax |
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Provider Business Mailing Address
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Address Line | 3302 GASTON AVE TAMU COLLEGE OF DENTISTRY - ENDODONTICS
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City | DALLAS
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State | TX
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Zip | 75246-2013
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Country | US
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Telephone | 214-828-8362
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 32301
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License Number State | TX
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