NATHAN CHONG

FAIRFAX, VA
NPI1194882001
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: VA  0401410829)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: CA  56152)
Enumeration Date2007-01-02
Last Update Date2013-03-04
Business Address
-- NATHAN CHONG
9428 MAIN ST
FAIRFAX, VA 22031-4032
Phone number: 703-323-5296
Mailing Address
-- NATHAN CHONG
9428 MAIN ST
FAIRFAX, VA 22031-4032
Phone number: 703-323-5296