Individual
JAEHO CHAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
483 MIDDLE TPKE W, MANCHESTER, CT 06040-3863
(860) 645-0111
Mailing address
323 7TH ST APT A, PALISADES PARK, NJ 07650-2271
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011104
CT
Other
Enumeration date
01/28/2014
Last updated
03/31/2016
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