| 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 |