Provider Demographics
NPI:1073121398
Name:CHOE, TEEBOK DAESUNG (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:TEEBOK
Middle Name:DAESUNG
Last Name:CHOE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 CONNER DR UNIT 105
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6112
Mailing Address - Country:US
Mailing Address - Phone:919-923-6931
Mailing Address - Fax:
Practice Address - Street 1:3200 BLUE RIDGE RD STE 122
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8087
Practice Address - Country:US
Practice Address - Phone:919-510-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC119311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1223G0001XDental ProvidersDentistGeneral Practice