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General NPI Number Information
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NPI Number | 1639210636
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Entity Type | Organization
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Legal Business Name | PETER Y. WON, D.D.S.,P.C.
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Dates
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Enumeration Date | 02/11/2007
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Last Update Date | 07/25/2014
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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 | 718-631-5393
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Provider Business Mailing 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 | 718-631-5393
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER YEE WON
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Credential | D.D.S.
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Telephone | 718-224-4200
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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 | 034517-1
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License Number State | NY
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