Provider Demographics
NPI:1558680835
Name:HONG, SUNG PYO (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUNG
Middle Name:PYO
Last Name:HONG
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 1:8511 SUMMERSWEET LN APT 22
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-7192
Mailing Address - Country:US
Mailing Address - Phone:919-824-9107
Mailing Address - Fax:
Practice Address - Street 1:912 ROBESON ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5614
Practice Address - Country:US
Practice Address - Phone:919-485-6136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8944122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist