Wong, Kenneth

Wong, Kenneth is an individual health care provider with primary practice located at 13575 W Indian School Rd Suite 300, Litchfield Park AZ 85340-4901. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Wong, Kenneth can be contacted via phone (623) 536-7789.

Contact Information

Primary practice address
13575 W Indian School Rd Suite 300 Litchfield Park AZ 85340-4901
Phone: (623) 536-7789
Fax: (623) 536-4743
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 6346 Arizona

Profile Details

NPI number 1376683425
LBN Legal business name Wong, Kenneth
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated Oct 29th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376683425 NPPES
Arizona MEDICAID D6346

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