Individual
SIEW-GING GONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BDS, MS, MA, PHD
Contact information
Practice address
2681 W GRAND BLVD, DETROIT, MI 48208-1233
(131) 387-5344
Mailing address
2681 W GRAND BLVD, DETROIT, MI 48208-1233
(131) 387-5344
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901016635
MI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901016635
MI
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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