Provider Demographics
NPI:1740379742
Name:WONG, ANDREW SIK HONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SIK HONG
Last Name:WONG
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:P.O. BOX 80586
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91118
Mailing Address - Country:US
Mailing Address - Phone:626-289-5288
Mailing Address - Fax:
Practice Address - Street 1:330 S GARFIELD AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3892
Practice Address - Country:US
Practice Address - Phone:626-289-5288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA334111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice