Individual
JONG BUM SEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-6189
(928) 289-6290
Mailing address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-6189
(928) 289-6290
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14142
MD
Other
Enumeration date
09/08/2008
Last updated
09/09/2008
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