Individual
MIJUNG MYUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
354 WAVERLEY ST, FRAMINGHAM, MA 01702
(508) 370-0113
Mailing address
650 LINCOLN ST, WORCESTER, MA 01605-2060
(508) 854-2122
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
PENDING
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/12/2018
Last updated
08/02/2018
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