Individual
CODY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1600 DEMPSTER ST STE 101, PARK RIDGE, IL 60068-1171
(847) 298-4436
Mailing address
2155 FARRELL AVE, PARK RIDGE, IL 60068-1164
(224) 436-9640
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.032264
IL
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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