DR. Rickey Lance Fong, DDS

NPI #1336346915 in Campbell, California

Provider Information

NPI Number: 1336346915
Entity Type: Individual
Name: DR. Rickey Lance Fong, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jun 28, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 621 E CAMPBELL AVE
Address 2: SUITE #4
City: Campbell
State: California
ZIP Code: 95008-2139
Phone: (408) 374-0501

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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