Provider Demographics
NPI:1164478624
Name:TONG, PETER P (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:P
Last Name:TONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 COURTHOUSE SQ
Mailing Address - Street 2:STE 105
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2337
Mailing Address - Country:US
Mailing Address - Phone:301-424-8888
Mailing Address - Fax:301-424-8667
Practice Address - Street 1:20 COURTHOUSE SQ
Practice Address - Street 2:STE 105
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2337
Practice Address - Country:US
Practice Address - Phone:301-424-8888
Practice Address - Fax:301-424-8667
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD125401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice