Individual
YEONJU ELIZABETH SON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12987
CT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12987
CT
Other
Enumeration date
05/24/2021
Last updated
09/01/2021
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