Individual
DENNIS WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25022 104TH AVE SE STE B, KENT, WA 98030-2822
(253) 859-0000
Mailing address
4542 E MERCER WAY, MERCER ISLAND, WA 98040-3830
(206) 862-8820
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE61096169
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2017
Last updated
10/14/2020
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