Organization
BRIAN R. FONG, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN R. FONG D.D.S. (PRESIDENT)
(510) 581-2142
Entity
Organization
Contact information
Practice address
21048 HAVILAND AVENUE, HAYWARD, CA 94541-2036
(510) 581-2142
(510) 581-1368
Mailing address
21048 HAVILAND AVENUE, HAYWARD, CA 94541-2036
(510) 581-2142
(510) 581-1368
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
38994
CA
Other
Enumeration date
05/24/2007
Last updated
11/04/2011
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