Provider Demographics
NPI:1306886528
Name:KWONG, ANSON HOO YIN (DDS)
Entity type:Individual
Prefix:DR
First Name:ANSON
Middle Name:HOO YIN
Last Name:KWONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9600 FAIRWAY DR.,
Mailing Address - Street 2:#150
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678
Mailing Address - Country:US
Mailing Address - Phone:916-788-8252
Mailing Address - Fax:916-788-8256
Practice Address - Street 1:9600 FAIRWAY DR.,
Practice Address - Street 2:#150
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678
Practice Address - Country:US
Practice Address - Phone:916-788-8252
Practice Address - Fax:916-788-8256
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA501541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice