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Individual
JAE H CHUN
Active
Individual
JAE H CHUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21577
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162811702
—
TX
01
—
G6003101
CHIP
TX
Enumeration date
05/12/2008
Last updated
05/12/2008
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