NPI | 1326587783 |
---|---|
Entity Type | Organization |
Authorized Contact | YOO JIN SHIN Member 347-563-5530 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CT 11353) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CT 11350) |
Enumeration Date | 2017-02-18 |
Last Update Date | 2017-02-18 |