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General NPI Number Information
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NPI Number | 1376275255
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Entity Type | Organization
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Legal Business Name | SEUNG C SON DDS, INC
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 2246 ROSECRANS AVE
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City | FULLERTON
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State | CA
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Zip | 92833-1742
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Country | US
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Telephone | 714-870-4111
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Fax | 714-870-0455
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Provider Business Mailing Address
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Address Line | 2246 ROSECRANS AVE
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City | FULLERTON
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State | CA
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Zip | 92833-1742
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Country | US
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Telephone | 714-870-4111
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Fax | 714-870-0455
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Authorized Official
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Title or Position | CEO
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Name | SEUNG CHEON SON
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Credential | DDS
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Telephone | 714-870-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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