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Individual

TITUS WONGK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
5901 PEACHTREE DUNWOODY RD STE B250, ATLANTA, GA 30328-7150
(470) 713-6770
Mailing address
5901 PEACHTREE DUNWOODY RD STE B250, ATLANTA, GA 30328-7150
(470) 713-6770

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D123381
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
05/18/2017
Last updated
12/18/2025
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