Organization
DAN W. FONG, D.D.S., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAN W. FONG D.D.S. (PRESIDENT/DENTIST)
(916) 451-2473
Entity
Organization
Contact information
Practice address
5659 STOCKTON BLVD, SUITE 2, SACRAMENTO, CA 95824-1611
(916) 451-2473
(916) 451-0620
Mailing address
5659 STOCKTON BLVD, SUITE 2, SACRAMENTO, CA 95824-1611
(916) 451-2473
(916) 451-0620
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
28440
CA
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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