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General NPI Number Information
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NPI Number | 1811181845
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Entity Type | Organization
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Legal Business Name | ANTHONY 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 | 3356 W BALL RD STE.215
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City | ANAHEIM
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State | CA
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Zip | 92804-3702
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Country | US
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Telephone | 714-995-3051
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Fax |
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Provider Business Mailing Address
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Address Line | 3356 W BALL RD STE.215
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City | ANAHEIM
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State | CA
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Zip | 92804-3702
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Country | US
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Telephone | 714-995-3051
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ANTHONY WONG
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Credential | D.D.S.
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Telephone | 714-995-3051
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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 | 37039
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License Number State | CA
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