Individual
JORDAN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 SW UNIVERSITY DR, WASECA, MN 56093
(507) 835-8972
Mailing address
175 18TH ST SW UNIT 211, OWATONNA, MN 55060-1157
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13744
MN
Other
Enumeration date
08/04/2016
Last updated
10/16/2020
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