Individual
ELAYNE WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4429 WASHINGTON RD, EVANS, GA 30809-6370
(706) 395-9031
Mailing address
130 N BIG CYPRESS DR APT 450, ST JOHNS, FL 32259-1966
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
123413
GA
1223G0001X
General Practice Dentistry
27971
FL
Other
Enumeration date
05/11/2023
Last updated
07/06/2024
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