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Individual

CONNIE WANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
930 16TH ST, SAN FRANCISCO, CA 94107
(415) 890-4449
Mailing address
1333 MARTIN LUTHER KING DR, HAYWARD, CA 94541-4397

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
103095
CA
390200000X
Student in an Organized Health Care Education/Training Program
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1508306267
CA
Enumeration date
02/28/2017
Last updated
12/20/2018
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