Dr. Otis T Chong, DMD
Dentist, Endodontics in Laguna Niguel, CA. Individual provider (NPI-1).
NPI number1861663148
StatusActive
Last updated in NPPESJan 25, 2017
Details
- NPI
- 1861663148
- Entity type
- Individual (NPI-1)
- Name
- Dr. Otis T Chong
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 14, 2008
- Last updated
- Jan 25, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223E0200X | Dentist, Endodontics | 56385 | CA | Yes |
| 122300000X | Dentist | 215521 | MA |
Practice location
30190 Town Center DriveSuite B
Laguna Niguel, CA 92677
Phone 949-363-2540 · Fax 949-363-3352
Mailing address
30190 Town Center DriveSuite B
Laguna Niguel, CA 92677
Phone 949-363-2540 · Fax 949-363-3352
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