Individual
JOHNSON FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
193 BOSTON TPKE STE 6140, SHREWSBURY, MA 01545-2552
(508) 669-7140
Mailing address
12 VANE ST, QUINCY, MA 02171-2314
(781) 244-9399
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1859825
MA
Other
Enumeration date
07/17/2023
Last updated
07/19/2023
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