Organization
AMY WONG D.D.S., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY WONG D.D.S. (PRESIDENT)
(626) 863-8575
Entity
Organization
Contact information
Practice address
1404 S SAN GABRIEL BLVD STE A, SAN GABRIEL, CA 91776-3603
(626) 863-8578
Mailing address
1404 S SAN GABRIEL BLVD STE A, SAN GABRIEL, CA 91776-3603
(626) 863-8578
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
56140
CA
Other
Enumeration date
02/18/2010
Last updated
11/02/2011
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