Provider Demographics
NPI:1447440607
Name:WANG ORTHODONTICS, LLC
Entity type:Organization
Organization Name:WANG ORTHODONTICS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:L
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:732-477-0080
Mailing Address - Street 1:525 ROUTE 70
Mailing Address - Street 2:SUITE 1-D
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4022
Mailing Address - Country:US
Mailing Address - Phone:732-477-0080
Mailing Address - Fax:732-477-3926
Practice Address - Street 1:525 ROUTE 70
Practice Address - Street 2:SUITE 1-D
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4022
Practice Address - Country:US
Practice Address - Phone:732-477-0080
Practice Address - Fax:732-477-3926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty