| Organization Name: | JULIUS M. KONG, D.D.S., INC. |
| NPI Number: | 1063583490 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULIUS MING-CHENG KONG (PRESIDENT) |
| Mailing Address: | 520 E Lake Ave Watsonville |
| State: | CA US |
| Postal Code: | 950764427 |
| Phone Number: | 8317244182 |
| Fax Number: | 8317243996 |
| NPI Enumeration Date: | 11/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 51094 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |