Provider Demographics
NPI:1013078740
Name:CHUONG, HEE RAN (DDS)
Entity Type:Individual
Prefix:
First Name:HEE RAN
Middle Name:
Last Name:CHUONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KRYSTLE
Other - Middle Name:HEERAN
Other - Last Name:CHUONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:515 OLD SWEDE RD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-1208
Mailing Address - Country:US
Mailing Address - Phone:610-385-0022
Mailing Address - Fax:610-385-0025
Practice Address - Street 1:515 OLD SWEDE RD
Practice Address - Street 2:
Practice Address - City:DOUGLASSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19518-1208
Practice Address - Country:US
Practice Address - Phone:610-385-0022
Practice Address - Fax:610-385-0025
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-028827L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice