| NPI | 1205278017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUNG NAM Prosthodontist 650-324-1292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA 55416) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2020-03-17 |