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General NPI Number Information
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NPI Number | 1376737304
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Entity Type | Organization
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Legal Business Name | NAOMI J. WONG, D.D.S.
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 415 W CHAPMAN AVE
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City | PLACENTIA
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State | CA
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Zip | 92870-5905
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Country | US
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Telephone | 714-223-2021
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Fax | 714-223-2021
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Provider Business Mailing Address
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Address Line | 415 W CHAPMAN AVE
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City | PLACENTIA
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State | CA
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Zip | 92870-5905
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Country | US
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Telephone | 714-223-2021
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Fax | 714-223-2021
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Authorized Official
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Title or Position | DENTIST
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Name | DR. NAOMI J. WONG
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Credential | D.D.S.
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Telephone | 714-223-2021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 37183
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License Number State | CA
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