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General NPI Number Information
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NPI Number | 1396040705
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Entity Type | Individual
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Provider Name | MYUNG SOO CHOI DDS
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Gender | Male
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 1017 E TRINITY MILLS RD #102
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City | CARROLLTON
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State | TX
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Zip | 75006-1438
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Country | US
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Telephone | 909-471-3782
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Fax |
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Provider Business Mailing Address
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Address Line | 620 N COPPELL RD #3602
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City | COPPELL
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State | TX
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Zip | 75019-2044
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Country | US
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Telephone | 909-471-3782
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Fax |
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 25816
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License Number State | TX
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