Individual
DR. MICHAEL JOSEPH WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5400 S CENTRAL AVE, PHOENIX, AZ 85040-3040
(602) 276-2713
Mailing address
5400 S CENTRAL AVE, PHOENIX, AZ 85040-3040
(602) 276-2713
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D434896
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150722
—
AZ
Enumeration date
05/21/2007
Last updated
07/09/2007
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