Individual
EDWARD SUNGWON NAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
351 LOUCKS RD STE E4, YORK, PA 17404-1740
(717) 848-3600
Mailing address
604 SE PEACOCK LN, PORTLAND, OR 97214-3236
(213) 604-2816
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS039563
PA
Other
Enumeration date
06/26/2013
Last updated
06/26/2013
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