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Contact Information

JORDAN WONG
1000 SW UNIVERSITY DR
WASECA, MN56093
 Phone: 507-835-8972
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JORDAN WONG · (Male)

NPI Number 1124572490
Status Active
Credentials
Entity Individual
Enumeration date 08/04/2016
Last updated 10/16/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # D13744
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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