Organization
HENRY VONG PROF DENTAL CORP
Active
Other names
Roseville Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY VONG D.D.S (PRESIDENT)
(415) 568-0761
Entity
Organization
Contact information
Practice address
1771 PLEASANT GROVE BLVD, STE 180, ROSEVILLE, CA 95747-8720
(916) 772-3847
(916) 273-3111
Mailing address
1771 PLEASANT GROVE BLVD, STE 180, ROSEVILLE, CA 95747-8720
(916) 772-3847
(916) 273-3111
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
60037
CA
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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