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General NPI Number Information
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NPI Number | 1447659610
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Entity Type | Organization
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Legal Business Name | JONG UK YOOK
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 3020 FLOYD AVE STE 609
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City | MODESTO
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State | CA
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Zip | 95355-9802
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Country | US
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Telephone | 209-551-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 FLOYD AVE STE 609
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City | MODESTO
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State | CA
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Zip | 95355-9802
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Country | US
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Telephone | 209-551-1414
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONG UK YOOK
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Credential | D.D.S.
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Telephone | 209-373-6537
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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 | 49434
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License Number State | CA
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