Individual
KIMBERLY TONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S, M.S.
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 916-3624
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 916-3624
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
28097
TX
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
28097
TX
Other
Enumeration date
02/27/2012
Last updated
10/06/2022
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