Individual
DR. ERIC THOMAS WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
23326 HAWTHORNE BLVD, SUITE 310, TORRANCE, CA 90505-3725
(310) 378-4220
Mailing address
23326 HAWTHORNE BLVD., SUITE 310, TORRANCE, CA 90505-3725
(310) 378-4220
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
58395
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508071358
—
CA
Enumeration date
05/14/2007
Last updated
04/03/2012
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