Individual
KATHLEEN WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 E MOYAMENSING AVE, PHILADELPHIA, PA 19148-1931
(215) 462-4047
Mailing address
501 E GIRARD AVE APT 301, PHILADELPHIA, PA 19125-3381
(561) 267-9147
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS044783
PA
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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