Organization
WANYUN XUE DENTAL P.C.
Active
Other names
Carroll Gardens Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WANYUN XUE DDS (OWNER)
(718) 852-3793
Entity
Organization
Contact information
Practice address
396 COURT ST, BROOKLYN, NY 11231-4206
(718) 852-3793
Mailing address
93 RAPELYE ST APT 2A, BROOKLYN, NY 11231-2629
(718) 852-3793
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054410-1
DENTAL LICENSE
NY
Enumeration date
09/17/2019
Last updated
12/06/2022
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