Provider Demographics
NPI:1205305992
Name:HEUNGKI MIN DDS A PROFESSIONAL CORP
Entity type:Organization
Organization Name:HEUNGKI MIN DDS A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HEUNGKI
Authorized Official - Middle Name:
Authorized Official - Last Name:MIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-266-0378
Mailing Address - Street 1:5881 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2021
Mailing Address - Country:US
Mailing Address - Phone:714-266-0378
Mailing Address - Fax:
Practice Address - Street 1:5881 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2021
Practice Address - Country:US
Practice Address - Phone:714-266-0378
Practice Address - Fax:714-266-0385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental