Individual
JEANNIE JIN WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4421 LONG PRAIRIE RD., #400, FLOWER MOUND, TX 75028
(972) 691-3636
Mailing address
302 WALNUT GROVE LN., COPPELL, TX 75019
(917) 403-6753
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
34592
TX
390200000X
Student in an Organized Health Care Education/Training Program
RES3773
OH
Other
Enumeration date
08/01/2016
Last updated
11/05/2019
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