| NPI | 1568788396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YONG-HAN KOO President 203-889-8916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: MA DN22058) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2010-04-19 |