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General NPI Number Information
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NPI Number | 1164647780
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Entity Type | Individual
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Provider Name | WON-SUCK OH DDS
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1011 N UNIVERSITY AVE BMS - PROSTHODONTICS
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City | ANN ARBOR
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State | MI
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Zip | 48109-1012
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Country | US
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Telephone | 734-615-2168
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Fax | 734-763-3453
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Provider Business Mailing Address
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Address Line | 1011 N UNIVERSITY AVE BMS - PROSTHODONTICS
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City | ANN ARBOR
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State | MI
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Zip | 48109-1012
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Country | US
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Telephone | 734-615-2168
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Fax | 734-763-3453
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901019423
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE00009575
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 53548
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License Number State | CA
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