D.wong, Dds, Dental Corporation

NPI #1174983779 in San Mateo, California

Provider Information

NPI Number: 1174983779
Entity Type: Organization
Organization Name: D.wong, Dds, Dental Corporation
Primary Specialty: Dentist
Enumeration Date: Feb 25, 2016
Last Updated: Feb 25, 2016

Practice Location

Address: 255 N SAN MATEO DR
Address 2: SUITE #2
City: San Mateo
State: California
ZIP Code: 94401-2655
Phone: (650) 347-7100

Authorized Official

Name: DR. DEREK WONG
Title: PRESIDENT
Phone: (650) 347-7100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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