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Individual

DR. JEFFREY H WONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
3400 PENROSE PL, SUITE 203, BOULDER, CO 80301-1809
(303) 444-6680
Mailing address
3400 PENROSE PL, SUITE 203, BOULDER, CO 80301-1809
(303) 444-6680

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8169
CO

Other

Enumeration date
05/08/2007
Last updated
07/08/2007
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