| NPI | 1457641136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIA HUI JENNY KWON Part Owner/ Dentist 917-453-4055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 010110) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 010241) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 010004) | |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |