Individual
JASON WONG
Active
Individual
JASON WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
057530
NY
122300000X
Dentist
9559
AZ
1223D0004X
Dental Anesthesiology
Primary
9559
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2013
Last updated
10/01/2023
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