Individual
DR. BRIAN WILLIAM FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3023 BROADWAY, REDWOOD CITY, CA 94062-1511
(650) 474-0551
(650) 474-0553
Mailing address
3023 BROADWAY, REDWOOD CITY, CA 94062-1511
(650) 474-0551
(650) 474-0553
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
50138
CA
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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