Provider Demographics
NPI:1962830349
Name:DRS. ROH, PARK AND HWANG, LLC
Entity Type:Organization
Organization Name:DRS. ROH, PARK AND HWANG, LLC
Other - Org Name:CLINTON DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:YOONCHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:443-618-2839
Mailing Address - Street 1:7700 OLD BRANCH AVE STE E102
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-1628
Mailing Address - Country:US
Mailing Address - Phone:301-449-3350
Mailing Address - Fax:301-952-8515
Practice Address - Street 1:7700 OLD BRANCH AVE STE E102
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1628
Practice Address - Country:US
Practice Address - Phone:301-449-3350
Practice Address - Fax:301-952-8515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty