Provider Demographics
NPI:1396040705
Name:CHOI, MYUNG SOO (DDS)
Entity Type:Individual
Prefix:
First Name:MYUNG SOO
Middle Name:
Last Name:CHOI
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 1:620 N COPPELL RD
Mailing Address - Street 2:#3602
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2044
Mailing Address - Country:US
Mailing Address - Phone:909-471-3782
Mailing Address - Fax:
Practice Address - Street 1:1017 E TRINITY MILLS RD
Practice Address - Street 2:#102
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-1438
Practice Address - Country:US
Practice Address - Phone:909-471-3782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX258161223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics