Provider Demographics
NPI:1023664935
Name:ESTEE WANG, DMD MS, PLLC
Entity type:Organization
Organization Name:ESTEE WANG, DMD MS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ESTEE
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS
Authorized Official - Phone:651-765-1945
Mailing Address - Street 1:4535 HODGSON RD STE 700
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-1955
Mailing Address - Country:US
Mailing Address - Phone:651-765-1945
Mailing Address - Fax:651-765-1949
Practice Address - Street 1:1668 COPE AVE E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2689
Practice Address - Country:US
Practice Address - Phone:651-777-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESTEE WANG, DMD MS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty