Individual
DR. SAMANTHA A WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
Mailing address
238 HAWK HOLLOW DR, BARTLETT, IL 60103-3056
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000
N/A
—
Enumeration date
01/21/2021
Last updated
01/21/2021
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