Organization
DEREK WONG PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK WONG DDS (PRESIDENT)
(213) 820-0351
Entity
Organization
Contact information
Practice address
430 S GARFIELD AVE STE 408, ALHAMBRA, CA 91801-3877
(626) 284-6626
(888) 574-6449
Mailing address
430 S GARFIELD AVE STE 408, ALHAMBRA, CA 91801-3877
(626) 284-6626
(888) 574-6449
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
58157
CA
Other
Enumeration date
12/12/2014
Last updated
12/12/2014
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