Individual
TIM T WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MPH
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2740
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN1858995
MA
Other
Enumeration date
06/04/2021
Last updated
04/29/2022
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