Provider Demographics
NPI:1619168176
Name:KYUNG B HUH DDS., INC
Entity Type:Organization
Organization Name:KYUNG B HUH DDS., INC
Other - Org Name:CENTRAL DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:KYUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:HUH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-668-2220
Mailing Address - Street 1:2211 FULKERTH RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-9535
Mailing Address - Country:US
Mailing Address - Phone:209-668-2220
Mailing Address - Fax:209-668-2227
Practice Address - Street 1:2211 FULKERTH RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-9535
Practice Address - Country:US
Practice Address - Phone:209-668-2220
Practice Address - Fax:209-668-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52062122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty