Individual
GRACE EUNHEE JEONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
5940 W UNION HILLS DR STE F110, GLENDALE, AZ 85308-1303
(602) 978-9575
Mailing address
20401 N 19TH AVE APT 2100, PHOENIX, AZ 85027-3579
(623) 337-7553
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6918
AZ
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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