DR. Ryan Fong, DMD

NPI #1174118848 in Las Vegas, Nevada

Provider Information

NPI Number: 1174118848
Entity Type: Individual
Name: DR. Ryan Fong, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Mar 4, 2021
Last Updated: Jun 8, 2021

Practice Location

Address: 1700 W. CHARLESTON BLVD
Address 2: M/S 7424
City: Las Vegas
State: Nevada
ZIP Code: 89102-2335
Phone: (702) 774-5175

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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