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General NPI Number Information
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NPI Number | 1508802588
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Entity Type | Organization
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Legal Business Name | 3-D DENTAL, PC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 01/22/2009
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Provider Practice Location Address
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Address Line | 203 TURNPIKE ST SUITE 100
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-5042
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Country | US
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Telephone | 978-688-6788
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Fax | 978-688-7588
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Provider Business Mailing Address
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Address Line | 203 TURNPIKE ST SUITE 100
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-5042
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Country | US
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Telephone | 978-688-6788
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Fax | 978-688-7588
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID WANG
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Credential | DMD
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Telephone | 978-688-6788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 19996
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 20540
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License Number State | MA
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