Provider Demographics
NPI:1497096150
Name:DUNWOODY PARK FAMILY DENTISTRY
Entity Type:Organization
Organization Name:DUNWOODY PARK FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNG-YUN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:678-395-5861
Mailing Address - Street 1:3 DUNWOODY PARK
Mailing Address - Street 2:SUITE 119
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-7405
Mailing Address - Country:US
Mailing Address - Phone:678-395-5861
Mailing Address - Fax:678-395-5903
Practice Address - Street 1:3 DUNWOODY PARK
Practice Address - Street 2:SUITE 119
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-7405
Practice Address - Country:US
Practice Address - Phone:678-395-5861
Practice Address - Fax:678-395-5903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013587261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental