Individual
JENNIFER FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
66 SOMME ST, NEWARK, NJ 07105-3612
(973) 288-2723
Mailing address
384 PATERSON AVE # 206, EAST RUTHERFORD, NJ 07073-1339
(916) 607-4992
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI02869600
NJ
Other
Enumeration date
11/27/2021
Last updated
11/27/2021
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