Provider Demographics
NPI:1669942835
Name:PENN DENTAL PARTNERS PLLC
Entity type:Organization
Organization Name:PENN DENTAL PARTNERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HYUNSIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:972-264-1662
Mailing Address - Street 1:800 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-1815
Mailing Address - Country:US
Mailing Address - Phone:972-264-1662
Mailing Address - Fax:972-264-8677
Practice Address - Street 1:800 S CENTER ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1815
Practice Address - Country:US
Practice Address - Phone:972-264-1662
Practice Address - Fax:972-264-8677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty