Provider Demographics
NPI:1356478416
Name:HONG, PETER T (DMD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:T
Last Name:HONG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 ALTOS OAKS DRIVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5433
Mailing Address - Country:US
Mailing Address - Phone:650-948-5600
Mailing Address - Fax:
Practice Address - Street 1:747 ALTOS OAKS DRIVE
Practice Address - Street 2:SUITE 3
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5433
Practice Address - Country:US
Practice Address - Phone:650-948-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA451151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice