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Individual

BRIAN FONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2364 GEARY BLVD, SAN FRANCISCO, CA 94115-3305
(415) 921-6722
Mailing address
555 W BENJAMIN HOLT DR, BUILDING B, STOCKTON, CA 95207-3839

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
56245
CA

Other

Enumeration date
09/20/2007
Last updated
09/20/2007
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