| Organization Name: | ROSE L. WANG DMD PLLC |
| NPI Number: | 1053796243 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JIPING CHENG (CEO) |
| Mailing Address: | 159 Main Dunstable Rd # Rd Suite 103 Nashua |
| State: | NH US |
| Postal Code: | 030603642 |
| Phone Number: | 6038827201 |
| Fax Number: | 6038829416 |
| NPI Enumeration Date: | 07/29/2015 |
| NPI Last Update Date: | 07/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 3059 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |