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General NPI Number Information
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NPI Number | 1750041273
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Entity Type | Organization
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Legal Business Name | COLUMBIA BROTHERS DENTAL GROUP
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Dates
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Enumeration Date | 12/23/2021
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 410 SPOTSWOOD ENGLISHTOWN RD
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City | MONROE
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State | NJ
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Zip | 08831-8615
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Country | US
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Telephone | 732-251-5252
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Fax |
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Provider Business Mailing Address
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Address Line | 410 SPOTSWOOD ENGLISHTOWN RD
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City | MONROE
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State | NJ
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Zip | 08831-8615
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Country | US
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Telephone | 732-251-5252
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JOON SEOK CHO
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Credential | DDS
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Telephone | 201-661-4665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #2
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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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