Provider Demographics
NPI:1417202417
Name:WANG, ESTEE P (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:ESTEE
Middle Name:P
Last Name:WANG
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:DR
Other - First Name:ESTEE
Other - Middle Name:WANG
Other - Last Name:BAJEMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD MS
Mailing Address - Street 1:1668 COPE AVE E
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2655
Mailing Address - Country:US
Mailing Address - Phone:651-356-9249
Mailing Address - Fax:
Practice Address - Street 1:1668 COPE AVE E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2655
Practice Address - Country:US
Practice Address - Phone:651-777-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND131441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics