NPI | 1619013802 |
---|---|
Entity Type | Organization |
Authorized Contact | YANGSUN BAK President 770-344-0170 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA Dn012678) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA Dn012679) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2020-08-22 |