Provider Demographics
NPI:1407060502
Name:TONG, MICHAEL KIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KIN
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 1:43925 HUGO TERRACE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538
Mailing Address - Country:US
Mailing Address - Phone:510-656-4292
Mailing Address - Fax:510-656-4229
Practice Address - Street 1:43925 HUGO TER
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-6061
Practice Address - Country:US
Practice Address - Phone:510-656-4292
Practice Address - Fax:510-656-4229
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43084122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist