| NPI | 1205323391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUNG WOOK BYUN Secretary 949-878-6680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 48707) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 54717) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 61057) | |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-04-16 |