Individual
DR. MICHAEL PETER WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2100 N BROAD ST, #203, LANSDALE, PA 19446-1052
(215) 855-4092
Mailing address
3273 BERRY BROW DR, CHALFONT, PA 18914-1066
(917) 604-1800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02295500
NJ
1223G0001X
General Practice Dentistry
052199
NY
1223P0221X
Pediatric Dentistry
Primary
DS037411
PA
Other
Enumeration date
03/21/2007
Last updated
09/27/2013
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