Provider Demographics
NPI:1467679415
Name:HAN, MIN CHUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIN
Middle Name:CHUL
Last Name:HAN
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 1:18391 COLIMA RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-2730
Mailing Address - Country:US
Mailing Address - Phone:626-854-2100
Mailing Address - Fax:626-854-2102
Practice Address - Street 1:18391 COLIMA RD
Practice Address - Street 2:SUITE 209
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-2730
Practice Address - Country:US
Practice Address - Phone:626-854-2100
Practice Address - Fax:626-854-2102
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA264181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice