Provider Demographics
NPI:1265265656
Name:YOO KYEOM HUH DMD MSD DENTAL CORP
Entity type:Organization
Organization Name:YOO KYEOM HUH DMD MSD DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOO KYEOM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:216-288-8459
Mailing Address - Street 1:5429 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-2212
Mailing Address - Country:US
Mailing Address - Phone:626-286-1122
Mailing Address - Fax:626-286-1123
Practice Address - Street 1:5429 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-2212
Practice Address - Country:US
Practice Address - Phone:626-286-1122
Practice Address - Fax:626-286-1123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty