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Organization
KENVIS NGOW DDS INC
Active
Organization
KENVIS NGOW DDS INC
Active
Other names
Reflection Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENVIS NGOW (DENTIST)
(909) 869-8856
Entity
Organization
Contact information
Practice address
21220 GOLDEN SPRINGS DR, WALNUT, CA 91789-3925
(909) 869-8856
(909) 869-7378
Mailing address
21220 GOLDEN SPRINGS DR, WALNUT, CA 91789-3925
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
48753
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G89806-01
MEDI-CAL
CA
Enumeration date
10/04/2007
Last updated
10/04/2007
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