Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 20856 | MA |
NPI | 1003085366 |
---|---|
Provider Name | Jinhyung Cho |
First Address | Lawrence, MA 01840-1214 |
Second Address | Lawrence, MA 01840-1214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2008 |
Last Update Date | 20/02/2008 |