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Organization
NORTHWEST FAMILY DENTISTRY
Active
Organization
NORTHWEST FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW WONG D.D.S. (GENERAL PARTNER)
(713) 861-7078
Entity
Organization
Contact information
Practice address
2120 W 18TH ST, HOUSTON, TX 77008-1210
(713) 861-7078
(713) 861-8065
Mailing address
2120 W 18TH ST, HOUSTON, TX 77008-1210
(713) 861-7078
(713) 861-8065
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
15415
TX
1223G0001X
General Practice Dentistry
Primary
15764
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009719801
—
TX
Enumeration date
02/14/2007
Last updated
05/29/2019
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