Provider Demographics
NPI:1336632116
Name:HYUN SHIK CHOI DDS PLLC
Entity Type:Organization
Organization Name:HYUN SHIK CHOI DDS PLLC
Other - Org Name:SAFARI SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-962-8520
Mailing Address - Street 1:10 SANCTUARY DR # 1
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1976
Mailing Address - Country:US
Mailing Address - Phone:347-393-1954
Mailing Address - Fax:
Practice Address - Street 1:100 W MARKET ST STE 202
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2564
Practice Address - Country:US
Practice Address - Phone:607-962-8520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0566881223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty