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Individual

DR. JONATHAN A WAASDORP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
10112 VALLEY FORGE CIR, SUITE 112, KING OF PRUSSIA, PA 19406-1111
(610) 783-0822
Mailing address
10112 VALLEY FORGE CIRCLE, SUITE 112, KING OF PRUSSIA, PA 19406
(610) 783-0822

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DS037114
PA

Other

Enumeration date
06/29/2009
Last updated
06/29/2009
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