| NPI | 1699261347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE K CHANG Owner 646-673-4496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02565000) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2021-03-30 |