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General NPI Number Information
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NPI Number | 1386061869
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Entity Type | Organization
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Legal Business Name | QIANMIN WANG DDS,INC
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 03/24/2014
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Provider Practice Location Address
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Address Line | 1129 W 4TH ST STE B
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City | MADERA
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State | CA
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Zip | 93637-4477
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Country | US
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Telephone | 559-395-4337
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Fax | 559-395-4602
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Provider Business Mailing Address
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Address Line | 1129 W 4TH ST STE B
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City | MADERA
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State | CA
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Zip | 93637-4477
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Country | US
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Telephone | 559-395-4337
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Fax | 559-395-4602
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. QIANMIN WANG
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Credential | DDS
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Telephone | 510-861-0928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 52018
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License Number State | CA
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