TEERACHAI SUPAKORNDEJ

ATHENS, GA
NPI1083953814
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: TX  28588)
Enumeration Date2013-02-14
Last Update Date2013-02-14
Business Address
-- TEERACHAI SUPAKORNDEJ
220 PLANTATION DR
ATHENS, GA 30605-4022
Phone number: 415-669-4187
Mailing Address
-- TEERACHAI SUPAKORNDEJ
220 PLANTATION DR
ATHENS, GA 30605-4022
Phone number:
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