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General NPI Number Information
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NPI Number | 1790340875
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Entity Type | Organization
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Legal Business Name | KIM & WANG DDS PLLC
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Dates
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Enumeration Date | 05/05/2019
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Last Update Date | 05/05/2019
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Provider Practice Location Address
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Address Line | 10737 71ST AVE STE 203
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City | FOREST HILLS
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State | NY
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Zip | 11375-4736
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Country | US
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Telephone | 718-261-1432
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Fax |
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Provider Business Mailing Address
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Address Line | 107-37 71ST AVE SUITE 203, MAILBOX #4
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City | FOREST HILLS
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State | NY
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Zip | 11375
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Country | US
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Telephone | 718-261-1432
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HOWARD HAO WANG
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Credential | DDS
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Telephone | 646-705-4908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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