| NPI | 1376891705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES CHANG Owner 718-483-9119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 054987-1) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |