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1649795964
GI TAE KWON
NEW LONDON, CT
NPI
1649795964
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: CT 11856)
Enumeration Date
2017-08-08
Last Update Date
2017-08-08
Business Address
DR. GI TAE KWON DDS
258 S FRONTAGE RD
NEW LONDON, CT 06320-2641
Phone number: 860-437-3462
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Mailing Address
DR. GI TAE KWON DDS
4003 MAPLE TREE LN
EAST LYME, CT 06333-1671
Phone number: 201-707-4661
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