GRANT RUSSELL FONG

SACRAMENTO, CA
NPI1174127138
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: CA  DDS105756)
Enumeration Date2020-11-30
Last Update Date2020-11-30
Business Address
Dr. GRANT RUSSELL FONG DDS
3000 L ST STE 215
SACRAMENTO, CA 95816-5248
Phone number: 916-457-7080
Mailing Address
Dr. GRANT RUSSELL FONG DDS
820 COBBLE COVE LN
SACRAMENTO, CA 95831-4309
Phone number: 916-217-3177
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