Individual
DR. JONATHAN S WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1190 S VICTORIA AVE, SUITE 305, VENTURA, CA 93003-6507
(805) 644-9664
Mailing address
204 PIRIE RD # B, OJAI, CA 93023-3135
(805) 640-9664
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
51675
CA
Other
Enumeration date
04/10/2007
Last updated
09/18/2009
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