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General NPI Number Information
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NPI Number | 1548501851
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Entity Type | Individual
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Provider Name | JENNIFER WON D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 11/13/2019
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Provider Practice Location Address
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Address Line | 444 ATLANTA HWY NW STE 500
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City | WINDER
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State | GA
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Zip | 30680
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Country | US
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Telephone | 470-394-2020
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Fax | 470-394-2030
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Provider Business Mailing Address
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Address Line | 444 ATLANTA HWY NW STE 500
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City | WINDER
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State | GA
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Zip | 30680-7894
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Country | US
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Telephone | 470-394-2020
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Fax | 470-394-2030
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401414127
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN015190
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License Number State | GA
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