Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS036687 | PA |
NPI | 1215018494 |
---|---|
Provider Name | Wenguang You |
First Address | Jb Mdl, NJ 08641-5312 |
Second Address | Jb Mdl, NJ 08641-5312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 10/05/2018 |