| NPI | 1578003901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAE KYUNG JUNG President 541-690-1656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OR 1657387-9) |
| Enumeration Date | 2017-03-04 |
| Last Update Date | 2017-03-04 |