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General NPI Number Information
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NPI Number | 1558076273
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Entity Type | Organization
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Legal Business Name | CHONG, KOK-HENG
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 24929 GODDARD RD
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City | TAYLOR
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State | MI
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Zip | 48180
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Country | US
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Telephone | 734-757-3014
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Fax |
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Provider Business Mailing Address
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Address Line | 24929 GODDARD RD
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City | TAYLOR
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State | MI
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Zip | 48180-3930
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Country | US
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Telephone | 734-757-3014
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Fax |
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Authorized Official
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Title or Position | PROSTHODONTIST
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Name | KOK-HENG CHONG
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Credential | DDS,MS
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Telephone | 734-757-3014
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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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