Nathan Chong
Dentist, General Practice in Fairfax, VA. Individual provider (NPI-1).
NPI number1194882001
StatusActive
Last updated in NPPESMar 4, 2013
Details
- NPI
- 1194882001
- Entity type
- Individual (NPI-1)
- Name
- Nathan Chong
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 2, 2007
- Last updated
- Mar 4, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 0401410829 | VA | Yes |
| 1223G0001X | Dentist, General Practice | 56152 | CA |
Practice location
9428 Main StFairfax, VA 22031-4032
Phone 703-323-5296 · Fax 703-503-3024
Mailing address
9428 Main StFairfax, VA 22031-4032
Phone 703-323-5296 · Fax 703-503-3024
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