| NPI | 1134512932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTINA CHO Owner 646-369-6918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 10227) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 10227) |
| Enumeration Date | 2015-03-18 |
| Last Update Date | 2015-07-15 |