Provider Demographics
NPI:1073067591
Name:TITANIUM DENTAL
Entity Type:Organization
Organization Name:TITANIUM DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHUNG
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:706-399-7266
Mailing Address - Street 1:3796 SATELLITE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5698
Mailing Address - Country:US
Mailing Address - Phone:888-414-6752
Mailing Address - Fax:888-414-6752
Practice Address - Street 1:3796 SATELLITE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5698
Practice Address - Country:US
Practice Address - Phone:888-414-6752
Practice Address - Fax:888-414-6752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0151241223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty