Individual
DAN C FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4323 HILL ST, COLUMBIA, SC 29207-6022
(803) 751-5221
Mailing address
4323 HILL ST, COLUMBIA, SC 29207-6022
(803) 751-5221
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
41249
CA
Other
Enumeration date
05/17/2006
Last updated
06/02/2016
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