Individual
HENLEY HERBERT FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9484 W LAKE MEAD BLVD STE 2, LAS VEGAS, NV 89134-8339
(702) 304-8338
Mailing address
8000 SPRING MOUNTAIN RD APT 1102, LAS VEGAS, NV 89117-3930
(702) 405-9198
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5279
NV
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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