Individual
NATHAN CHONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9428 MAIN ST, FAIRFAX, VA 22031-4032
(703) 323-5296
(703) 503-3024
Mailing address
9428 MAIN ST, FAIRFAX, VA 22031-4032
(703) 323-5296
(703) 503-3024
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410829
VA
1223G0001X
General Practice Dentistry
56152
CA
Other
Enumeration date
01/02/2007
Last updated
03/04/2013
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