| NPI | 1386812501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHONGMIN PARK President 718-762-3361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 050303) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-02-11 |