Provider Demographics
NPI:1851846836
Name:EUN JU PAIK DDS INC
Entity Type:Organization
Organization Name:EUN JU PAIK DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EUN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-337-5117
Mailing Address - Street 1:3441 W BALL RD STE A
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3767
Mailing Address - Country:US
Mailing Address - Phone:657-337-5117
Mailing Address - Fax:
Practice Address - Street 1:3441 W BALL RD STE A
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3767
Practice Address - Country:US
Practice Address - Phone:657-337-5117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55545122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty