Organization · Type 2 NPI

Michael R. Wang, Dds, Inc.

Dental Clinic/Center · Fremont, CA

NPI number 1790367100 Active

Practice location

43480 Mission Blvd Unit 160
Fremont, CA 94539-5892

Fax (510) 980-7328

Specialties and licenses

Taxonomy	Code	License
Dental Clinic/Center Primary	261QD0000X	None listed

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NPI record

NPI: 1790367100
Entity type: Organization (Type 2)
Issued: Apr 26, 2021
Last updated: Jun 10, 2021
Status: Active

Other names

<unavail>
Mission Peak Pediatric Dentistry · doing business as
Mission Peak Pediatric Dentistry · doing business as

Authorized official

Dr. Michael Wang, DDS
President
(510) 980-7325

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About NPI 1790367100

Michael R. Wang, Dds, Inc.'s National Provider Identifier is 1790367100, issued on Apr 26, 2021. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Fremont, CA. The record was last updated on Jun 10, 2021.