Provider Demographics
NPI:1457665770
Name:SEOK, HAK (DDS)
Entity Type:Individual
Prefix:
First Name:HAK
Middle Name:
Last Name:SEOK
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 1:9171 BALTIMORE NATIONAL PIKE STE 125
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3944
Mailing Address - Country:US
Mailing Address - Phone:410-720-2261
Mailing Address - Fax:
Practice Address - Street 1:9171 BALTIMORE NATIONAL PIKE STE 125
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3944
Practice Address - Country:US
Practice Address - Phone:410-720-2261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD145871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice