Individual
DR. WALLACE F. CHONG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
74 PONAHAWAI ST, HILO, HI 96720-3026
(808) 935-5651
(808) 935-5551
Mailing address
74 PONAHAWAI ST, HILO, HI 96720-3026
(808) 935-5651
(808) 935-5551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DT-729
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065295-01
—
HI
Enumeration date
02/28/2007
Last updated
07/08/2007
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