Provider Demographics
NPI:1336306307
Name:WANG, MING MICHAEL (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MING
Middle Name:MICHAEL
Last Name:WANG
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13910 CHAMPION FOREST DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-1882
Mailing Address - Country:US
Mailing Address - Phone:281-580-5588
Mailing Address - Fax:
Practice Address - Street 1:13910 CHAMPION FOREST DR
Practice Address - Street 2:SUITE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-1882
Practice Address - Country:US
Practice Address - Phone:281-580-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179471223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics