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Individual

STEFANIE WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
ONE LYONS STREET, DEDHAM, MA 02026
(781) 329-1400
(781) 278-5667
Mailing address
PO BOX 9120, DEDHAM, MA 02027-9120
(781) 329-1400
(781) 278-5667

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19821
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0022795
NEIGHBORHOOD HEALTH PLAN
01
AA45100
FIRST SENIORITY
01
V06218
DENTAL BLUE
Enumeration date
08/05/2006
Last updated
07/08/2007
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