Grant Russell Fong
ActiveCalifornia license 105756
License
- Licensed by
- Dental Board of California
- License number
- 105756
- Status
- Active (Current)
- First issued
- October 26, 2020
- Expires
- January 31, 2027
- License holder
- Grant Russell Fong
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
7446 Braeridge Way
Sacramento, CA 95831-4004
Sacramento, CA 95831-4004
Sacramento County