Most Relevant Information
Provider Data
| NPI Number: | 1003028028 |
| Provider Name: | JUSTINE STACEY WONG DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 4599 |
Most Important Dates
| Enumeration Date: | 05/03/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
917 MOUNTAIN STREET
CARSON CITY
NV
89703
Practice Location Phone/Fax
| Phone: | 7758886887 |
| Fax: |
Provider Mailing Location
917 MOUNTAIN STREET
CARSON CITY
NV
89703
Provider Mailing Phone/Fax
| Phone: | 7758886887 |
| Fax: |