Provider Demographics
NPI:1891469854
Name:WANG, ALLEN DEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:DEE
Last Name:WANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12118 CIELIO BAY LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-5737
Mailing Address - Country:US
Mailing Address - Phone:850-696-3736
Mailing Address - Fax:
Practice Address - Street 1:9440 BELLAIRE BLVD STE 112
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4558
Practice Address - Country:US
Practice Address - Phone:713-773-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX376491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice