Individual
BO MI CHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
380 UNION AVE, BROOKLYN, NY 11211-3429
(347) 986-2032
Mailing address
494 9TH AVE APT 4A, NEW YORK, NY 10018-4124
(925) 597-3386
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
063635
NY
122300000X
Dentist
108996
CA
Other
Enumeration date
03/30/2022
Last updated
10/16/2024
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