Individual
DR. JASON P. GANONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
UNIT 26610, WUERZBURG DENTAL ACTIVITY CREDENTIALS OFFICE, APO AE, NY 09244
(931) 804-3933
(931) 804-2524
Mailing address
UNIT 26610, WUERZBURG DENTAL ACTIVITY CREDENTIALS OFFICE, APO AE, NY 09244
(931) 804-3933
(931) 804-2524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS036238
PA
Other
Enumeration date
12/28/2005
Last updated
07/08/2007
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