| Diane Wong Dds Pllc | |
|
254 Canal St Room 4008 New York NY 10013-3501 | |
| (212) 966-3649 | |
| (212) 966-3986 |
| Full Name | Diane Wong Dds Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 254 Canal St, New York, New York |
| Authorized Official Name and Position | Diane Wong (OWNER) |
| Authorized Official Contact | 6468838997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane Wong Dds Pllc 6385 Woodhaven Blvd Apt. 3g Rego Park NY 11374-4844 Ph: () - | Diane Wong Dds Pllc 254 Canal St Room 4008 New York NY 10013-3501 Ph: (212) 966-3649 |
| NPI Number | 1538601729 |
|---|---|
| Provider Enumeration Date | 11/05/2016 |
| Last Update Date | 11/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538601729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 046946 (New York) | Primary |
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