Individual
CHANGHYUN JUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3724 JEFFERSON ST STE 100, AUSTIN, TX 78731-6219
(512) 452-4661
Mailing address
107 VAILCO LN, AUSTIN, TX 78738-6565
(805) 835-5134
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
36971
TX
261QD0000X
Dental Clinic/Center
1005932
CA
Other
Enumeration date
03/06/2021
Last updated
01/16/2023
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