Individual
LAM KHANH VUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
678 N WILSON WAY, STOCKTON, CA 95205-4272
(209) 235-0226
Mailing address
678 N WILSON WAY, STOCKTON, CA 95205-4272
(209) 235-0226
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
105433
CA
Other
Enumeration date
08/07/2018
Last updated
09/04/2020
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