Healthcare Provider Details

I. General information

NPI: 1639155989
Provider Name (Legal Business Name): EUNHEE CRYSTAL CHOI D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 LIBERTY PL
SICKLERVILLE NJ
08081-5705
US

IV. Provider business mailing address

1 MARKET ST APT 333
CAMDEN NJ
08102-2313
US

V. Phone/Fax

Practice location:
  • Phone: 856-629-0577
  • Fax:
Mailing address:
  • Phone: 401-617-2143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDI022957
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: