Provider Demographics
NPI:1255642963
Name:SUNG MIN SUH DDS, INC
Entity type:Organization
Organization Name:SUNG MIN SUH DDS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNG MIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-861-3131
Mailing Address - Street 1:4050 BARRANCA PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-1725
Mailing Address - Country:US
Mailing Address - Phone:949-861-3131
Mailing Address - Fax:949-387-7600
Practice Address - Street 1:4050 BARRANCA PKWY STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-1725
Practice Address - Country:US
Practice Address - Phone:949-861-3131
Practice Address - Fax:949-387-7600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA584571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty