Individual
JACK ELLIOT WASSERSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
27450 TOURNEY RD, SUITE 100, VALENCIA, CA 91355-1828
(661) 254-8484
(661) 254-8669
Mailing address
27450 TOURNEY RD, SUITE 100, VALENCIA, CA 91355-1828
(661) 254-8484
(661) 254-8669
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
36297
CA
Other
Enumeration date
07/29/2010
Last updated
07/29/2010
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