MEDICARE: DR. DEBBY HOI-YEE WONG 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	053303-1	NY
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	24506	TX

General Provider Information

NPI Number	:	1992940076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBBY HOI-YEE WONG DMD

Provider Business Mailing Address
First Line	:	3930 MCKINNEY AVE
Second Line	:	APT. 577
City	:	DALLAS
State	:	TX
Zip	:	75204-2016
Country	:	US
Telephone Number	:	917-864-0609
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 W I-20
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-1435
Country	:	US
Telephone Number	:	917-864-0609
Fax Number	:

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

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	07/27/2011

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