Provider Demographics
NPI:1174296966
Name:CHO, SUNG HOON (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUNG HOON
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:TED
Other - Middle Name:
Other - Last Name:CHO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:50 ANDREWS WAY # 7-306
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-6982
Mailing Address - Country:US
Mailing Address - Phone:630-923-2666
Mailing Address - Fax:
Practice Address - Street 1:1540 PLEASANT VALLEY RD STE G
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-8760
Practice Address - Country:US
Practice Address - Phone:630-923-2666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13170122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist