Provider Demographics
NPI:1134598733
Name:XIONG, TRUE (DDS)
Entity type:Individual
Prefix:
First Name:TRUE
Middle Name:
Last Name:XIONG
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 1:110 MCKIBBIN ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-6408
Mailing Address - Country:US
Mailing Address - Phone:509-944-1105
Mailing Address - Fax:
Practice Address - Street 1:ZACHARY & ELIZABETH FISHER MEDICAL & DENTAL CLINIC
Practice Address - Street 2:2470 SAMPSON STREET
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:60088
Practice Address - Country:US
Practice Address - Phone:847-688-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9421751-9921122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist