Provider Demographics
NPI:1871090480
Name:MARVIN TONG, DDS, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:MARVIN TONG, DDS, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-268-6284
Mailing Address - Street 1:27450 TOURNEY RD STE 130
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1851
Mailing Address - Country:US
Mailing Address - Phone:661-286-6284
Mailing Address - Fax:661-286-6289
Practice Address - Street 1:27450 TOURNEY RD STE 130
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1851
Practice Address - Country:US
Practice Address - Phone:661-286-6284
Practice Address - Fax:661-286-6289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty