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General NPI Number Information
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NPI Number | 1194845743
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Entity Type | Organization
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Legal Business Name | JENNIFER E. WONG-LOOI, DDS, PA
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 240 W PALMETTO PARK RD 205
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City | BOCA RATON
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State | FL
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Zip | 33432-3761
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Country | US
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Telephone | 561-393-9122
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Fax |
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Provider Business Mailing Address
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Address Line | 240 W PALMETTO PARK RD 205
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City | BOCA RATON
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State | FL
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Zip | 33432-3761
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DAVID LOOI
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Credential |
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Telephone | 561-393-9122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13200
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License Number State | FL
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