Individual
KIMBERLY ANN FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
876 BOARDWALK PLACE, REDWOOD CITY, CA 94065-1809
(415) 640-3274
(650) 593-3327
Mailing address
PO BOX 171, BRISBANE, CA 94005-0171
(415) 640-3274
(650) 593-3327
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HAP353
CA
Other
Enumeration date
09/07/2011
Last updated
09/07/2011
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