Lawrence Eugene Fong, DDS Valid NPI

Individual provider · General Practice Dentistry · Fairfax, CA

NPI

1366652117

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

22068 (CA)

Sex

Male

Sole proprietor

Yes

Enumerated

2007-05-23

Last updated

2007-07-08