Individual
DR. JONATHAN Z WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
104 4TH STREET, BLADENBORO, NC 28320
(910) 863-2377
Mailing address
104 4TH STREET, BLADENBORO, NC 28320
(910) 863-2377
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5992
LA
1223G0001X
General Practice Dentistry
Primary
8894
NC
Other
Enumeration date
07/01/2009
Last updated
01/07/2010
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