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Individual

DR. HARRISON VONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
2030 N DIXIE HWY, ELIZABETHTOWN, KY 42701
(502) 935-0505
Mailing address
2030 N DIXIE HWY, ELIZABETHTOWN, KY 42701
(270) 872-0347

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9677
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
27556
KY
Enumeration date
09/29/2015
Last updated
06/06/2017
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