Provider Demographics
NPI:1780237818
Name:WANG, WILLIAM P (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:P
Last Name:WANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 W 9 MILE RD APT 510
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-3037
Mailing Address - Country:US
Mailing Address - Phone:347-322-2073
Mailing Address - Fax:
Practice Address - Street 1:1113 BOARDMAN RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-1901
Practice Address - Country:US
Practice Address - Phone:571-768-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401416552122300000X
MI2901601386122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist