Organization
WILSON WONG, DDS, INC
Active
Organization
WILSON WONG, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILSON WONG DDS (PRESIDENT/CEO)
(415) 753-0333
Entity
Organization
Contact information
Practice address
2340 IRVING ST, SUITE 105, SAN FRANCISCO, CA 94122-1641
(415) 753-0333
(415) 753-1899
Mailing address
2340 IRVING ST, SUITE 105, SAN FRANCISCO, CA 94122-1641
(415) 753-0333
(415) 753-1899
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
B36856
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G-93552-01
DENTI-CAL
CA
Enumeration date
11/28/2007
Last updated
11/28/2007
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