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Individual
JOHN BORAM WON
Active
Individual
JOHN BORAM WON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
55828
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55828
STATE LICENSE
CA
Enumeration date
09/22/2008
Last updated
09/22/2008
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