MEDICARE: C.S. DENTAL, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	9648	CO

General Provider Information

NPI Number	:	1891929113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C.S. DENTAL, PLLC

Provider Business Mailing Address
First Line	:	6825 E HAMPDEN AVE
Second Line	:	101
City	:	DENVER
State	:	CO
Zip	:	80224-3029
Country	:	US
Telephone Number	:	303-756-3289
Fax Number	:

Provider Business Practice Location Address
First Line	:	6825 E HAMPDEN AVE
Second Line	:	101
City	:	DENVER
State	:	CO
Zip	:	80224-3029
Country	:	US
Telephone Number	:	303-756-3289
Fax Number	:	303-756-0862

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BUHM JOON SOHN
Credential	:	DDS
Telephone Number	:	303-756-3289

Provider Enumeration Date	:	05/14/2009
Last Update Date	:	05/14/2009

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