Organization
DIANE WONG DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE WONG (OWNER)
(646) 883-8997
Entity
Organization
Contact information
Practice address
254 CANAL ST, ROOM 4008, NEW YORK, NY 10013-3501
(212) 966-3649
(212) 966-3986
Mailing address
6385 WOODHAVEN BLVD, APT. 3G, REGO PARK, NY 11374-4844
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
046946
NY
Other
Enumeration date
11/05/2016
Last updated
11/18/2016
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