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General NPI Number Information
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NPI Number | 1780850164
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Entity Type | Organization
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Legal Business Name | BENJAMIN H WANG D D S INC.
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 682 VILLA ST STE A
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94041-1375
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Country | US
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Telephone | 650-968-3616
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Fax | 650-968-1728
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Provider Business Mailing Address
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Address Line | 682 VILLA ST STE A
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94041-1375
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Country | US
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Telephone | 650-968-3616
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BENJAMIN H WANG
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Credential | DDS
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Telephone | 650-968-3616
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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 | 40039
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License Number State | CA
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