| Brian R. Fong, D.d.s., Inc. | |
|
21048 Haviland Avenue Hayward CA 94541-2036 | |
| (510) 581-2142 | |
| (510) 581-1368 |
| Full Name | Brian R. Fong, D.d.s., Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 21048 Haviland Avenue, Hayward, California |
| Authorized Official Name and Position | Brian R. Fong (PRESIDENT) |
| Authorized Official Contact | 5105812142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian R. Fong, D.d.s., Inc. 21048 Haviland Avenue Hayward CA 94541-2036 Ph: (510) 581-2142 | Brian R. Fong, D.d.s., Inc. 21048 Haviland Avenue Hayward CA 94541-2036 Ph: (510) 581-2142 |
| NPI Number | 1093926842 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 11/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093926842 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 38994 (California) | Primary |
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