| NPI | 1477006799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOUNG SOO JANG Owner 267-632-5774 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA ds030832l) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |