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WONG & PHAM DDS INC. NPI 1417128034


NPI Information

NPI: 1417128034
Provider Name: WONG & PHAM DDS, INC.

Doing Business As: EAGLE GLEN DENTAL GROUP

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
3811 BEDFORD CANYON RD STE 105
CORONA, CA
ZIP 92883
Phone: (951) 270-0211
Get Directions

WONG & PHAM DDS, INC. is a general practice dentist in Corona, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. WONG & PHAM DDS, INC. NPI is 1417128034. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Eagle Glen Dental Group.

The provider's business location address is:

3811 BEDFORD CANYON RD STE 105
CORONA, CA
ZIP 92883-789
Phone: (951) 270-0211
Fax: (951) 270-0702

The provider's authorized official is Pauline Pham Wong .
The authorized official title is President and has the following contact phone number (951) 270-0211.

The enumeration date for this NPI number is 3/24/2008 and was last updated on 3/24/2008.


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
11223G0001XDentistGeneral Practice53643CALIFORNIAYes

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: 5/5/2024

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