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General NPI Number Information
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NPI Number | 1538056601
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Entity Type | Individual
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Provider Name | SEUNGJOON HWANG
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Gender | Male
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Dates
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Enumeration Date | 06/21/2025
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 6100 DAYLONG LN STE 204
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1655
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Country | US
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Telephone | 667-200-5912
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Fax |
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Provider Business Mailing Address
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Address Line | 653 W LEXINGTON ST APT 31G
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City | BALTIMORE
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State | MD
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Zip | 21201-1553
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Country | US
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Telephone | 281-507-8042
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18653
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License Number State | MD
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