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General NPI Number Information
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NPI Number | 1801581897
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Entity Type | Organization
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Legal Business Name | JENNIFER WON DDS, LLC
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Dates
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Enumeration Date | 04/06/2023
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Last Update Date | 04/06/2023
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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 | 30680-7894
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Country | US
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Telephone | 470-394-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 2538 GADSEN WALK
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City | DULUTH
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State | GA
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Zip | 30097-4349
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Country | US
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Telephone | 734-358-9958
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER WON
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Credential | DDS
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Telephone | 734-358-9958
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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 |
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License Number State |
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