NPI | 1124231659 |
---|---|
Former Name | THOMAS KINGSLEY DONG |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: CA 37056) |
Additional Taxonomies | 122300000X Dentist (Licence: CA B3705601) |
Enumeration Date | 2007-05-08 |
Last Update Date | 2012-07-02 |