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General NPI Number Information
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NPI Number | 1447870662
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Entity Type | Organization
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Legal Business Name | DARRYL C CHONG DDS DENTAL CORP
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Dates
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Enumeration Date | 04/17/2020
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 13861 BEACH BLVD STE 4
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City | WESTMINSTER
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State | CA
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Zip | 92683-4035
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Country | US
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Telephone | 714-897-4471
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Fax |
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Provider Business Mailing Address
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Address Line | 3083 W TERANIMAR DR
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City | ANAHEIM
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State | CA
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Zip | 92804-3826
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Country | US
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Telephone | 714-408-8206
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MARIE M HOANG
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Credential |
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Telephone | 714-310-5356
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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 |
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License Number State |
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