Provider Demographics
NPI:1184791436
Name:YOON, THOMAS YOUNG HO (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:YOUNG HO
Last Name:YOON
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 W WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2927
Mailing Address - Country:US
Mailing Address - Phone:407-647-4180
Mailing Address - Fax:407-647-3765
Practice Address - Street 1:1311 W WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2927
Practice Address - Country:US
Practice Address - Phone:407-647-4180
Practice Address - Fax:407-647-3765
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN174601223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics