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Individual

JEFFREY FONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
9411 65TH RD, SUITE 1B, REGO PARK, NY 11374-4627
(374) 682-5688
Mailing address
9411 65TH RD, SUITE 1B, REGO PARK, NY 11374-4627
(347) 682-5688

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
056689-1
NY
1223P0221X
Pediatric Dentistry
22DI02502400
NJ

Other

Enumeration date
04/25/2011
Last updated
10/20/2015
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