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Individual

DR. DERICK WANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1455 AUSTIN HWY, SAN ANTONIO, TX 78209-4455
(412) 897-0174
Mailing address
12803 WEST AVE, APT 19207, SAN ANTONIO, TX 78216-1813

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
29793
TX
122300000X
Dentist
DS038440
PA

Other

Enumeration date
10/08/2010
Last updated
07/24/2014
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