Individual
COLLEEN GAYLE KONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1410 BENT DR, CAMPBELL, CA 95008-3608
(408) 412-3658
Mailing address
1410 BENT DR, CAMPBELL, CA 95008-3608
(408) 412-3658
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
26014
CA
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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