Provider Demographics
NPI:1326239047
Name:TONY WANG D.D.S., INC.
Entity Type:Organization
Organization Name:TONY WANG D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:CHUN-HAI
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-484-9063
Mailing Address - Street 1:1803 W SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-3226
Mailing Address - Country:US
Mailing Address - Phone:213-484-9063
Mailing Address - Fax:
Practice Address - Street 1:1803 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-3226
Practice Address - Country:US
Practice Address - Phone:213-484-9063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental