Individual
RUSSELL WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.D.
Contact information
Practice address
10568 RAVENNA RD, STE 5, TWINSBURG, OH 44087-1654
(440) 446-1819
(440) 442-2316
Mailing address
10568 RAVENNA RD, STE 5, TWINSBURG, OH 44087-1654
(440) 446-1819
(440) 442-2316
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
30-020060
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0285436
—
OH
Enumeration date
03/27/2007
Last updated
05/17/2017
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