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DR. SANDRA JEAN GONG DDS

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1104966241

Individual Registrant:
DR. SANDRA JEAN GONG DDS
Gender: F
Sole Proprietor

Location and contact information for practice:
101 COMANCHE DR  ARVIN, CA 93203-0172 US
Tel: 661-854-5558  Fax: 661-854-2696

Contact information for business:
PO BOX 172  ARVIN, CA 93203-0172 US
Tel: 661-854-5558  Fax: 661-854-2696

Registration Information:
NPI: 1104966241
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
CA29891

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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