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Organization
JAMES WONG DENTAL CORP.
Active
Organization
JAMES WONG DENTAL CORP.
Active
Other names
Maywood Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES T WONG DDS (DENTIST)
(323) 771-6000
Entity
Organization
Contact information
Practice address
4509 E. SLAUSON AVE STE B, MAYWOOD, CA 90270-2954
(323) 771-6000
Mailing address
4509 E. SLAUSON AVE STE B, MAYWOOD, CA 90270-2954
(323) 771-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
42713
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G93151-02
—
CA
Enumeration date
01/22/2007
Last updated
08/22/2020
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