DR. Debra A Gong, D.D.S.

NPI #1053539981 in Chicago, Illinois

Provider Information

NPI Number: 1053539981
Entity Type: Individual
Name: DR. Debra A Gong, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Apr 23, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 820 S DAMEN AVE
Address 2: DENTAL SERVICE, JESSE BROWN VAMC
City: Chicago
State: Illinois
ZIP Code: 60612-3728
Phone: (312) 569-6669

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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