Organization
MOTT STREET DENTAL P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IVY X. WANG D.D.S (PRESIDENT)
(212) 732-5875
Entity
Organization
Contact information
Practice address
2 MOTT ST RM 303, NEW YORK, NY 10013-5003
(212) 732-5875
Mailing address
2 MOTT ST RM 303, NEW YORK, NY 10013-5003
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
049014
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02758381
—
NY
Enumeration date
05/21/2007
Last updated
08/22/2020
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