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1255358172
GRANT JONG
RIVERSIDE, CA
NPI
1255358172
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: CA 42666)
Enumeration Date
2006-07-16
Last Update Date
2007-07-08
Business Address
Dr. GRANT JONG D.M.D.
6180 BROCKTON AVE SUITE 201
RIVERSIDE, CA 92506-2228
Phone number: 951-684-5611
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Mailing Address
Dr. GRANT JONG D.M.D.
6180 BROCKTON AVE SUITE 201
RIVERSIDE, CA 92506-2228
Phone number: 951-684-5611
Copy
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