Individual
BETHANY WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 W CHAPMAN AVE, PLACENTIA, CA 92870-5905
(714) 223-2021
Mailing address
415 W CHAPMAN AVE, PLACENTIA, CA 92870-5905
(714) 223-2021
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
108930
CA
Other
Enumeration date
07/21/2023
Last updated
07/24/2023
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