Provider Demographics
NPI:1639421951
Name:SSCL CORP PLLC
Entity Type:Organization
Organization Name:SSCL CORP PLLC
Other - Org Name:ALL FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOJIN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:CHON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-599-9446
Mailing Address - Street 1:1315 W. MAIN AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:TX
Mailing Address - Zip Code:78573
Mailing Address - Country:US
Mailing Address - Phone:956-599-9446
Mailing Address - Fax:956-599-9449
Practice Address - Street 1:1315 W. MAIN AVE STE 10
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:TX
Practice Address - Zip Code:78573
Practice Address - Country:US
Practice Address - Phone:956-599-9446
Practice Address - Fax:956-599-9449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX306207701Medicaid