| NPI | 1487177036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERICK WANG President 412-897-0174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 100859) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2017-07-25 |