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MICHAEL CHUNG

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1619488319

Individual Registrant:
 MICHAEL  CHUNG 
Gender: M
Sole Proprietor

Location and contact information for practice:
581 FOSTER CITY BLVD  FOSTER CITY, CA 94404-1695 US
Tel: 650-286-9999  Fax: --

Contact information for business:
6434 OVERLOOK DR  ALEXANDRIA, VA 22312-1327 US
Tel: 703-618-4709  Fax: --

Registration Information:
NPI: 1619488319
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
CADDS103011
N390200000XStudent
Organized Health Care Education/Training Program

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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