| NPI | 1124472949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY JIYOUNG AHN Dentist 917-518-7497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |