Individual
DR. AMY WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3811 204TH ST, BAYSIDE, NY 11361-1864
(917) 378-1190
Mailing address
3811 204TH ST, BAYSIDE, NY 11361-1864
(917) 378-1190
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
057296
NY
Other
Enumeration date
04/27/2013
Last updated
01/29/2021
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