| NPI | 1104125855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW WOOSUNG KWON Dentist 626-960-2766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 52627) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 54659) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2011-03-21 |