Organization
LAKELAND FAMILY DENTAL
Active
Parent organization
FU WONG DDS
Organization subpart
Yes
Provider details
NPI number
Legal business name
FU WONG DDS
Authorized official
FU WONG DDS (PRESIDENT)
(763) 424-4415
Entity
Organization
Contact information
Practice address
106 BROADWAY STREET EAST, MONTICELLO, MN 55362
(763) 295-3036
(763) 295-4514
Mailing address
106 BROADWAY ST EAST, MONTICELLO, MN 55362-9351
(763) 295-3036
(763) 295-4514
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10739
MN
Other
Enumeration date
06/09/2008
Last updated
06/13/2008
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