Individual
CLARK FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
401A N SAN MATEO DR, SAN MATEO, CA 94401-2417
(650) 344-7626
(650) 344-2850
Mailing address
401A N SAN MATEO DR, SAN MATEO, CA 94401-2417
(650) 344-7626
(650) 344-2850
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40351
CA
Other
Enumeration date
09/28/2007
Last updated
09/28/2007
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