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Individual

AILEEN JONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
101 OAKRIDGE CT STE C, WATERTOWN, WI 53094-4150
(920) 261-5400
Mailing address
1346 N 4TH ST UNIT 10, WATERTOWN, WI 53098-3441

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002633-15
WI

Other

Enumeration date
07/13/2021
Last updated
07/13/2021
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