Individual
CHENGLONG ZHAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3485 MADISON ST, RIVERSIDE, CA 92504-3716
(909) 264-0308
Mailing address
7679 ROTUNDA CT, RIVERSIDE, CA 92507-0111
(909) 264-0308
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
109326
CA
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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