John Wang, DDS
Dentist, General Practice in Teecnospos, AZ. Individual provider (NPI-1).
NPI number1881997682
StatusActive
Last updated in NPPESAug 17, 2021
Details
- NPI
- 1881997682
- Entity type
- Individual (NPI-1)
- Name
- John Wang
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 16, 2010
- Certification date
- Jul 26, 2021
- Last updated
- Aug 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 60057 | CA | Yes |
Practice location
Us Hwy 160 & Navajo Route 35 - Red MesaTeecnospos, AZ 86514
Phone 928-656-5000
Mailing address
Po Box 160Shiprock, NM 87420-0160
Phone 928-656-5000
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