Provider Demographics
NPI:1184903940
Name:OH, ALBERT EUNSUK (DDS)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:EUNSUK
Last Name:OH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11821 WESTMINSTER CT
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-4174
Mailing Address - Country:US
Mailing Address - Phone:714-323-8007
Mailing Address - Fax:
Practice Address - Street 1:11821 WESTMINSTER CT
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-4174
Practice Address - Country:US
Practice Address - Phone:714-323-8007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60608122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist