Provider Demographics
NPI:1265466411
Name:HAROLD HAKSUN CHOI D.D.S INC.
Entity Type:Organization
Organization Name:HAROLD HAKSUN CHOI D.D.S INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:HAKSUN
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-343-9500
Mailing Address - Street 1:4723 W MAIN ST
Mailing Address - Street 2:SUITE #C
Mailing Address - City:GUADALUPE
Mailing Address - State:CA
Mailing Address - Zip Code:93434-1787
Mailing Address - Country:US
Mailing Address - Phone:805-343-9500
Mailing Address - Fax:805-343-9505
Practice Address - Street 1:4723 W MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:GUADALUPE
Practice Address - State:CA
Practice Address - Zip Code:93434-1787
Practice Address - Country:US
Practice Address - Phone:805-343-9500
Practice Address - Fax:805-343-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA451001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty