| NPI | 1295271450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE C KANG President 720-990-0381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CO 55871) |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CO 202361) |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2017-01-12 |