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Individual

TIFFANY CHUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1600 S EAST RD, FARMINGTON, CT 06032-2610
(860) 676-0050
Mailing address
2183 MCCLELLAN ST, EAST MEADOW, NY 11554-2010

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13517
CT
1223G0001X
General Practice Dentistry
PENDING
CT
261QS1000X
Student Health Clinic/Center
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/01/2022
Last updated
07/14/2022
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