Organization
MEDFORD ENDODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK G WANG D.M.D. (PRESIDENT)
(781) 391-5100
Entity
Organization
Contact information
Practice address
ZERO GOVERNORS AVENUE, SUITE 30, MEDFORD, MA 02155-3006
(781) 391-5100
(781) 391-4833
Mailing address
ZERO GOVERNORS AVENUE., SUITE 30, MEDFORD, MA 02155-0000
(781) 391-5100
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
20514
MA
Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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