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General NPI Number Information
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NPI Number | 1588016497
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Entity Type | Individual
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Provider Name | SAMUEL CHOI DDS
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Gender | Male
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Dates
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Enumeration Date | 07/05/2016
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Last Update Date | 07/05/2016
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Provider Practice Location Address
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Address Line | 56 GARDEN ST
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City | SEYMOUR
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State | CT
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Zip | 06483-2961
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Country | US
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Telephone | 203-463-8192
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Fax |
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Provider Business Mailing Address
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Address Line | 4012 165TH ST 2ND FLOOR
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City | FLUSHING
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State | NY
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Zip | 11358-2622
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Country | US
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Telephone | 917-843-8282
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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 | 11652
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License Number State | CT
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