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Individual

DR. CONG PENG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
6821 STEWART RD, GALVESTON, TX 77551-1841
(781) 627-6588
Mailing address
3433 COVE VIEW BLVD APT 3533, GALVESTON, TX 77554-8175
(781) 627-6588

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
34144
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
34144
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34144
DENTAL LICENSE
TX
Enumeration date
06/15/2018
Last updated
04/14/2023
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