Provider Demographics
NPI:1518058544
Name:CHUN, TERRY LEE (DDS)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LEE
Last Name:CHUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 SOUTH COLUMBIAN WAY
Mailing Address - Street 2:BOX 358280
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-8280
Mailing Address - Country:US
Mailing Address - Phone:206-764-2324
Mailing Address - Fax:206-768-5382
Practice Address - Street 1:1660 SOUTH COLUMBIAN WAY
Practice Address - Street 2:BOX 358280
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-8280
Practice Address - Country:US
Practice Address - Phone:206-764-2324
Practice Address - Fax:206-768-5382
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000103361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice