| NPI | 1548882863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUKYEOM KIM Owner 915-845-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 125Q00000X Oral Medicinist |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2021-10-26 |