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General NPI Number Information
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NPI Number | 1447715743
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Entity Type | Organization
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Legal Business Name | J CHUN DENTAL CORP
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Dates
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Enumeration Date | 01/31/2019
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Last Update Date | 05/17/2019
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Provider Practice Location Address
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Address Line | 1112 W 6TH ST STE 105
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City | CORONA
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State | CA
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Zip | 92882-3137
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Country | US
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Telephone | 951-200-5553
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Fax | 951-200-5501
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Provider Business Mailing Address
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Address Line | 1112 W 6TH ST STE 105
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City | CORONA
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State | CA
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Zip | 92882-3137
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Country | US
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Telephone | 951-200-5553
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Fax | 951-200-5501
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Authorized Official
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Title or Position | OWNER
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Name | JIHEE CHUN
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Credential | DDS
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Telephone | 909-984-4444
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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 |
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License Number State |
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