Individual
JIEUN CHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
616 FELLSWAY, MEDFORD, MA 02155-4959
(781) 306-9644
Mailing address
616 FELLSWAY, MEDFORD, MA 02155-4959
(781) 306-9644
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1857438
MA
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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