Chan Kwon Chung Valid NPI

Individual provider · Periodontics · Teaneck, NJ

NPI

1558983270

Type

Individual (Type 1)

Primary specialty

Periodontics (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223P0300X

License number

22DI03066000 (NJ)

Sex

Male

Sole proprietor

Yes

Enumerated

2020-05-15

Last updated

2026-03-30