DR. Ian Shane Fong, D.D.S.
NPI #1568449197 in Pembroke Pines, Florida
Provider Information
- NPI Number
- 1568449197
- Entity Type
- Individual
- Name
- DR. Ian Shane Fong, D.D.S.
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Dentist - General Practice
- Credential
- D.D.S.
- Enumeration Date
- Dec 23, 2005
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1900 N UNIVERSITY DR
- Address 2
- STE 201
- City
- Pembroke Pines
- State
- Florida
- ZIP Code
- 33024-3618
- Phone
- (954) 432-8992
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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