| NPI | 1437526357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOUNGCHUL KIM Owner 917-334-3544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CT 010809) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2015-10-19 |