Provider Demographics
NPI:1164647780
Name:OH, WON-SUCK (DDS)
Entity Type:Individual
Prefix:DR
First Name:WON-SUCK
Middle Name:
Last Name:OH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N UNIVERSITY AVE
Mailing Address - Street 2:BMS - PROSTHODONTICS
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1012
Mailing Address - Country:US
Mailing Address - Phone:734-615-2168
Mailing Address - Fax:734-763-3453
Practice Address - Street 1:1011 N UNIVERSITY AVE
Practice Address - Street 2:BMS - PROSTHODONTICS
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1012
Practice Address - Country:US
Practice Address - Phone:734-615-2168
Practice Address - Fax:734-763-3453
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019423122300000X
WADE00009575122300000X
CA53548122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist