| NPI | 1366606816 |
|---|---|
| Former Name | SEONG JOON OK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GA DN014635) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 22248) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2015-07-07 |