| 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 |