Provider Demographics
NPI:1598829806
Name:WONG, ROSEMARY CHIT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:CHIT
Last Name:WONG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 S AVENUE A
Mailing Address - Street 2:SUITE 1
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8336
Mailing Address - Country:US
Mailing Address - Phone:928-782-1490
Mailing Address - Fax:
Practice Address - Street 1:2241 S AVENUE A
Practice Address - Street 2:SUITE 1
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8336
Practice Address - Country:US
Practice Address - Phone:928-782-1490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice