Individual
DR. NAMIE KONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
27271
TX
1223P0221X
Pediatric Dentistry
Primary
64577
CA
Other
Enumeration date
08/25/2011
Last updated
11/23/2015
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