Individual
DR. SARUNPHORN RASAMIMARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
128 MOTT ST STE 403, NEW YORK, NY 10013-5575
(219) 218-5920
Mailing address
111 3RD AVE APT 2K, NEW YORK, NY 10003-5519
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
060777-01
NY
1223P0221X
Pediatric Dentistry
12390
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2017
Last updated
04/29/2020
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