Provider Demographics
NPI:1043993470
Name:SEONGRO YOON DDS INC.
Entity Type:Organization
Organization Name:SEONGRO YOON DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SEONGRO
Authorized Official - Middle Name:ARRON
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-803-2964
Mailing Address - Street 1:7337 EAST AVE.
Mailing Address - Street 2:SUITE A
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336
Mailing Address - Country:US
Mailing Address - Phone:909-803-2964
Mailing Address - Fax:909-803-2968
Practice Address - Street 1:7337 EAST AVE.
Practice Address - Street 2:SUITE A
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336
Practice Address - Country:US
Practice Address - Phone:909-803-2964
Practice Address - Fax:909-803-2968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty