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Individual

HO RYUN CHUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
170 W MAIN ST, APT# 205K, MILFORD, CT 06460-2562
(714) 334-5001
Mailing address
170 W MAIN ST, APT#205K, MILFORD, CT 06460-2562
(714) 334-5001

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
010653
CT
122300000X
Dentist
055859
NY
1223G0001X
General Practice Dentistry
Primary
010653
CT

Other

Enumeration date
10/12/2011
Last updated
01/14/2013
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