| NPI | 1508451063 |
|---|---|
| Other Name | CHANGHYUN JUNG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 36971) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CA 1005932) |
| Enumeration Date | 2021-03-06 |
| Last Update Date | 2023-01-16 |