Individual
NORMAN GONG WAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
38149 MARTHA AVE, FREMONT, CA 94536-3800
(510) 797-4430
(510) 797-4615
Mailing address
38149 MARTHA AVE, FREMONT, CA 94536-3800
(510) 797-4430
(510) 797-4615
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN27707
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN27707
DENTAL LICENCE NUMBER
CA
Enumeration date
01/13/2007
Last updated
07/08/2007
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