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General NPI Number Information
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NPI Number | 1194150029
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Entity Type | Individual
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Provider Name | CHRISTINE CHUNG DMD
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Gender | Female
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 560 SPRINGFIELD AVENUE, SUITE L
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City | WESTFIELD
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State | NJ
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Zip | 07090
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Country | US
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Telephone | 908-264-8335
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Fax |
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Provider Business Mailing Address
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Address Line | 25 RENFIELD DRIVE
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City | PRINCETON
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State | NJ
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Zip | 08540
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Country | US
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Telephone | 609-933-0296
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02547200
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License Number State | NJ
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