Provider Demographics
NPI:1457796484
Name:TONG, TONY HAOYU
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:HAOYU
Last Name:TONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SHERMAN RD
Mailing Address - Street 2:TONY TONG PC
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3181
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:126 UNION ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1207
Practice Address - Country:US
Practice Address - Phone:508-481-4200
Practice Address - Fax:508-481-4242
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18562861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice