| NPI | 1659885523 |
|---|---|
| Doing Business As | PREMIER DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JONGSUNG KIM CEO 671-300-3221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GU D1014) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223P0300X Dentist, Periodontics | |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |