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General NPI Number Information
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NPI Number | 1558751610
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Entity Type | Individual
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Provider Name | DR. PETER YEE WON
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Gender | Male
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 4727 BELL BLVD
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City | BAYSIDE
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State | NY
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Zip | 11361-3333
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Country | US
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Telephone | 718-224-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 20 HEMINGWAY DR
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City | DIX HILLS
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State | NY
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Zip | 11746-5915
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Country | US
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Telephone | 631-421-1987
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 034517-1
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License Number State | NY
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