Individual
DR. JAE JOON MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
26113 HOOVER RD, WARREN, MI 48089-1147
(586) 393-5686
Mailing address
515 RIVERSIDE DRIVE WEST, #1306, WINDSOR, ON N9A 7-C3
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901601091
MI
1223G0001X
General Practice Dentistry
Primary
2901601091
MI
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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