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Individual

DR. LUCY A. CHAN-WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
2209 WOOD AVE, ROSELLE, NJ 07203-2930
(908) 245-5556
Mailing address
2209 WOOD AVE, ROSELLE, NJ 07203-2930
(908) 245-5556

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DI 13810
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3336301
NJ
Enumeration date
02/10/2007
Last updated
07/08/2007
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