| James Wong Dental Corp. | |
|
4509 E. Slauson Ave Ste B Maywood CA 90270-2954 | |
| (323) 771-6000 | |
| Not Available |
| Full Name | James Wong Dental Corp. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4509 E. Slauson Ave Ste B, Maywood, California |
| Authorized Official Name and Position | James T Wong (DENTIST) |
| Authorized Official Contact | 3237716000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James Wong Dental Corp. 4509 E. Slauson Ave Ste B Maywood CA 90270-2954 Ph: (323) 771-6000 | James Wong Dental Corp. 4509 E. Slauson Ave Ste B Maywood CA 90270-2954 Ph: (323) 771-6000 |
| NPI Number | 1073667945 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073667945 | NPI | - | NPPES |
| G93151-02 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 42713 (California) | Primary |
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