Provider Demographics
NPI:1194848622
Name:HUH, KYUNG B (DDS)
Entity Type:Individual
Prefix:DR
First Name:KYUNG
Middle Name:B
Last Name:HUH
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 1:2211 FULKERTH RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-9535
Mailing Address - Country:US
Mailing Address - Phone:209-668-2220
Mailing Address - Fax:209-668-2227
Practice Address - Street 1:2211 FULKERTH RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-9535
Practice Address - Country:US
Practice Address - Phone:209-668-2220
Practice Address - Fax:209-668-2227
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52062122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist