Individual
ILLNAHM CHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2102 E OSCEOLA PKWY STE 21022104, KISSIMMEE, FL 34743-8630
(407) 201-3998
Mailing address
8224 VIA VERONA, ORLANDO, FL 32836-7700
(321) 279-4633
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15949
FL
Other
Enumeration date
09/30/2008
Last updated
02/28/2011
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