NPI | 1285667972 |
---|---|
Former Name | KYUNG WON CHUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 51563) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 20693) |
Enumeration Date | 2006-07-08 |
Last Update Date | 2015-09-21 |