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General NPI Number Information
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NPI Number | 1750013900
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Entity Type | Organization
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Legal Business Name | CHUNG & LEE DENTAL CORP
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 07/03/2022
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Provider Practice Location Address
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Address Line | 258 S OXFORD AVE STE 101
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City | LOS ANGELES
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State | CA
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Zip | 90004-5172
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Country | US
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Telephone | 213-385-8242
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Fax |
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Provider Business Mailing Address
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Address Line | 258 S OXFORD AVE STE 101
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City | LOS ANGELES
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State | CA
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Zip | 90004-5172
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER CHUNG
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Credential |
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Telephone | 323-401-9221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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