| NPI | 1114898129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAE EUN YOU Manager 415-317-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2026-02-12 |