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Individual
TU-SON NGO
Active
Individual
TU-SON NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0401411494
VA
1223E0200X
Endodontics
13212
MD
1223E0200X
Endodontics
49162
CA
Other
Enumeration date
07/31/2006
Last updated
09/17/2007
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