| NPI | 1154838068 |
|---|---|
| Former Legal Business Name | CHATHAM SQUARE DENTAL ASSOCIATE PC |
| Entity Type | Organization |
| Authorized Contact | GLENN HO NGAN President 212-385-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2018-01-02 |