Individual
KEITH B WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1818 E MERCER ST, SUITE 200, SEATTLE, WA 98112-4687
(206) 812-4494
(206) 812-4490
Mailing address
1818 E MERCER ST, SUITE 200, SEATTLE, WA 98112-4687
(206) 812-4494
(206) 812-4490
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE60262326
WA
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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