| NPI | 1033622246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIA HUI JENNY KWON Member 917-453-4055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 010110) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |