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ELAINE ABANTE BERSABA VONG DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1215563622

Individual Registrant:
 ELAINE ABANTE BERSABA VONG DDS
Gender: F
Not Sole Proprietor

Location and contact information for practice:
12821 MAIN ST STE 150  HESPERIA, CA 92345-9130 US
Tel: 760-947-9853  Fax: --

Contact information for business:
12481 KOKOMO CT  VICTORVILLE, CA 92392-6780 US
Tel: 775-848-1212  Fax: --

Registration Information:
NPI: 1215563622
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N122300000XDental Providers
Dentist
CADDS103724
Y1223G0001XDental Providers
Dentist
CADDS103724

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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