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Organization
PETER FONG, DDS, INC.
Active
Organization
PETER FONG, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER FONG (PRESIDENT)
(415) 472-2770
Entity
Organization
Contact information
Practice address
1050 NORTHGATE DR STE 139, SAN RAFAEL, CA 94903-2559
(415) 472-2770
Mailing address
1050 NORTHGATE DR STE 139, SAN RAFAEL, CA 94903-2559
(415) 472-2770
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40817
CA
Other
Enumeration date
05/09/2007
Last updated
08/17/2009
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