Provider Demographics
NPI:1497985667
Name:WONG, JOYCE LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:LEE
Last Name:WONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 BEE CAVES RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5676
Mailing Address - Country:US
Mailing Address - Phone:512-329-9900
Mailing Address - Fax:
Practice Address - Street 1:2712 BEE CAVES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5676
Practice Address - Country:US
Practice Address - Phone:512-329-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24821122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist