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NPI Code Detail

MEDICARE: DR. DEWEY TONG DDS

MEDICARE: DR. DEWEY TONG DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223E0200XEndodontics40401CA

General Provider Information

NPI Number : 1295933257
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEWEY TONG DDS
Provider Business Mailing Address
First Line : 1337 BANCROFT AVE
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-5103
Country : US
Telephone Number : 510-351-2812
Fax Number : 510-351-2832
Provider Business Practice Location Address
First Line : 1337 BANCROFT AVE
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94577-5103
Country : US
Telephone Number : 510-351-2812
Fax Number : 510-351-2832
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2007
Last Update Date : 07/10/2007

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Directions to “ DR. DEWEY TONG DDS” Practice Location

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