Michael Dennis Wong D.D.S.

NPI 1417093402 - Dentist - 1223G0001X

NPI Details
NPI 1417093402
Gender Male
Enumeration Date 01/29/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1304 15TH ST
203
SANTA MONICA CA, 90404-1809, US
Phone (310) 451-3139
Fax (310) 394-7578
Business Location
1304 15TH ST
203
SANTA MONICA CA, 90404-1809, US
Phone (310) 451-3139
Fax (310) 394-7578
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 25043
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According to our database, Dr. Michael Dennis Wong D.D.S. NPI is 1417093402, taxonomy code is 1223G0001X and license number is 25043, license state is located at California. Michael Dennis Wong D.D.S. physically located at 1304 15th St, Santa Monica CA, 90404-1809. NPI Number Michael Dennis Wong D.D.S. has the Individual type.

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1417093402 NPI number is provided on an as is basis without warranty of any kind. 1417093402 is maintained by the National Plan & Provider Enumeration System. The contents of Michael Dennis Wong D.D.S. are for informational purposes only.