Organization
MOWA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MORLEY WANG DDS (DENTIST)
(917) 833-2063
Entity
Organization
Contact information
Practice address
9411 59TH AVE STE A5, ELMHURST, NY 11373-5158
(718) 924-2555
Mailing address
3626 215TH PL, BAYSIDE, NY 11361-2209
(917) 833-2063
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03519275
—
NY
Enumeration date
05/17/2019
Last updated
05/17/2019
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