Healthcare Provider Details

I. General information

NPI: 1871291393
Provider Name (Legal Business Name): DREAM DENTAL PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4041 W WHEATLAND RD STE 202
DALLAS TX
75237-4061
US

IV. Provider business mailing address

901 ROSEMARY DR
FLOWER MOUND TX
75028-5102
US

V. Phone/Fax

Practice location:
  • Phone: 626-755-3751
  • Fax:
Mailing address:
  • Phone: 626-755-3751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: HYUNSIK SAMUEL SUNG
Title or Position: OWNER
Credential: DMD
Phone: 626-755-3751