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General NPI Number Information
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NPI Number | 1194795690
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Entity Type | Individual
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Provider Name | NATHAN JOHN WONDER D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 309 E 2ND ST
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City | POMONA
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State | CA
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Zip | 91766-1854
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Country | US
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Telephone | 949-307-9685
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Fax |
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Provider Business Mailing Address
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Address Line | 309 E 2ND ST
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City | POMONA
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State | CA
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Zip | 91766-1854
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Country | US
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Telephone | 949-307-9685
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DDS109634
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License Number State | CA
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