NPI | 1881979672 |
---|---|
Other Name | PHILIP HORYUN CHUNG |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 010653) |
Additional Taxonomies | 122300000X Dentist (Licence: CT 010653) |
122300000X Dentist (Licence: NY 055859) | |
Enumeration Date | 2011-10-12 |
Last Update Date | 2013-01-14 |