Individual
DR. TIM KUN WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
550 UNIVERSITY BLVD, UH-3143, INDIANAPOLIS, IN 46202-5149
(317) 274-5315
Mailing address
550 UNIVERSITY BLVD # UH-3143, JENNIFER FAIRES- RESIDENCY COORDINATOR, INDIANAPOLIS, IN 46202-5149
(317) 274-5315
(317) 278-2243
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12013077A
IN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
34914
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/07/2014
Last updated
06/19/2020
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