| NPI | 1699167288 |
|---|---|
| Former Name | CELESTE KONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN16979) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MA DN16979) |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2015-02-19 |