| Peter Fong, Dds, Inc. | |
|
1050 Northgate Dr Ste 139 San Rafael CA 94903-2559 | |
| (415) 472-2770 | |
| Not Available |
| Full Name | Peter Fong, Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1050 Northgate Dr Ste 139, San Rafael, California |
| Authorized Official Name and Position | Peter Fong (PRESIDENT) |
| Authorized Official Contact | 4154722770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Fong, Dds, Inc. 1050 Northgate Dr Ste 139 San Rafael CA 94903-2559 Ph: (415) 472-2770 | Peter Fong, Dds, Inc. 1050 Northgate Dr Ste 139 San Rafael CA 94903-2559 Ph: (415) 472-2770 |
| NPI Number | 1578777918 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 08/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578777918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 40817 (California) | Primary |
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