Provider Demographics
NPI:1184991929
Name:CHOE, KYONG SIK (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:KYONG
Middle Name:SIK
Last Name:CHOE
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 1:660 KENILWORTH DR
Mailing Address - Street 2:SUIT 103
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2313
Mailing Address - Country:US
Mailing Address - Phone:410-821-8800
Mailing Address - Fax:410-523-5715
Practice Address - Street 1:660 KENILWORTH DR
Practice Address - Street 2:SUIT 103
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2313
Practice Address - Country:US
Practice Address - Phone:410-821-8800
Practice Address - Fax:410-523-5715
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13004122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist