Individual
DR. BENNETT C. JEONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1075 VIA VERDE, SAN DIMAS, CA 91773-4347
(909) 599-8331
Mailing address
1075 VIA VERDE, SAN DIMAS, CA 91773-4347
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
27306
CA
Other
Enumeration date
11/21/2005
Last updated
07/08/2007
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