Individual
DR. KI YOON CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
6404 ROOSEVELT BLVD, PHILADELPHIA, PA 19149-2943
(215) 214-5994
Mailing address
1425 LOCUST ST UNIT 8B, PHILADELPHIA, PA 19102-3834
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS040680
PA
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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