Provider Demographics
NPI:1649525460
Name:CHOI, SEUNG KYU (DMD)
Entity type:Individual
Prefix:DR
First Name:SEUNG
Middle Name:KYU
Last Name:CHOI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 309
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:SC
Mailing Address - Zip Code:29138-9199
Mailing Address - Country:US
Mailing Address - Phone:864-445-8168
Mailing Address - Fax:864-445-2535
Practice Address - Street 1:101 R L SAWYER MD DR
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:SC
Practice Address - Zip Code:29138-9199
Practice Address - Country:US
Practice Address - Phone:864-445-8168
Practice Address - Fax:864-445-2535
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC80861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice