Provider Demographics
NPI:1912198953
Name:WONG, CHRISTOPHER P (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:P
Last Name:WONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2121 YGNACIO VALLEY RD
Mailing Address - Street 2:BLDG. E STE. 202
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3383
Mailing Address - Country:US
Mailing Address - Phone:925-933-0677
Mailing Address - Fax:925-933-2698
Practice Address - Street 1:2121 YGNACIO VALLEY RD
Practice Address - Street 2:BLDG. E STE. 202
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3383
Practice Address - Country:US
Practice Address - Phone:925-933-0677
Practice Address - Fax:925-933-2698
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA543201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice