MEDICARE: ZHENG WANG DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30023020	OH

General Provider Information

NPI Number	:	1689802357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZHENG WANG DMD

Provider Business Mailing Address
First Line	:	4168 BUCKEYE PKWY
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123
Country	:	US
Telephone Number	:	614-801-5620
Fax Number	:	614-871-1252

Provider Business Practice Location Address
First Line	:	4168 BUCKEYE PKWY
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-8175
Country	:	US
Telephone Number	:	614-801-5620
Fax Number	:	614-871-1252

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2009
Last Update Date	:	10/17/2014

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