C F WONG BETA DENTAL INCORPORATED NPI 1225527765

NPI Information

NPI: 1225527765
Provider Name: C F WONG BETA DENTAL INCORPORATED

Doing Business As: MAGNOLIA DENTAL

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1042 PACIFIC ST STE B
SAN LUIS OBISPO, CA
ZIP 93401
Phone: (805) 543-6963
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C F WONG BETA DENTAL INCORPORATED is a dental clinic center in San Luis Obispo, CA. C F WONG BETA DENTAL INCORPORATED NPI is 1225527765. The provider is registered as an organization entity type.
The provider Is Doing Business As Magnolia Dental.

The provider's business location address is:

1042 PACIFIC ST STE B
SAN LUIS OBISPO, CA
ZIP 93401-661
Phone: (805) 543-6963
Fax: (805) 543-8656

The provider's authorized official is Christopher F. Wong .
The authorized official title is Owner and has the following contact phone number (805) 543-6963.

The enumeration date for this NPI number is 5/9/2018 and was last updated on 6/16/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NONE	OTHER		NONE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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