| NPI | 1205630787 |
|---|---|
| Doing Business As | EASTERN AVENUE DENTAL |
| Entity Type | Organization |
| Authorized Contact | HONG SON President 415-810-6548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2025-04-03 |
| Last Update Date | 2025-04-03 |