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Organization
SANDRA J GONG DDS DENTAL CORP.
Active
Organization
SANDRA J GONG DDS DENTAL CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA J GONG DDS (CHIEF EXECUTIVE OFFICER)
(661) 854-5558
Entity
Organization
Contact information
Practice address
101 COMANCHE DR, ARVIN, CA 93203-0172
(661) 854-5558
(661) 854-2696
Mailing address
PO BOX 172, ARVIN, CA 93203-0172
(661) 854-5558
(661) 854-2696
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
29891
CA
Other
Enumeration date
02/09/2007
Last updated
10/03/2014
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