Individual
JAIMIE MONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 MAIN ST, GREENVILLE, PA 16125-2139
(724) 588-8910
Mailing address
206 MAIN ST, GREENVILLE, PA 16125-2139
(724) 588-8910
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS040385
PA
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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