Individual provider · NPI-1

Taejoon Ahn, DMD

Dentist · Waltham, MA

NPI number1104042118
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1104042118
Entity type
Individual (NPI-1)
Name
Taejoon Ahn
Credential
DMD
Sex
Male
Sole proprietor
No
Enumeration date
Apr 18, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist19072MAYes

Practice location

225 Moody St
Waltham, MA 02453

Phone 781-647-8000 · Fax 781-647-8111

Mailing address

225 Moody St
Waltham, MA 02453

Phone 781-647-8000 · Fax 781-647-8111

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