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General NPI Number Information
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NPI Number | 1619605326
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Entity Type | Organization
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Legal Business Name | SEUNG JAE JOUNG DMD PLLC
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 22205 MERIDIAN E STE 109
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City | GRAHAM
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State | WA
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Zip | 98338-9781
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Country | US
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Telephone | 253-875-6599
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Fax |
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Provider Business Mailing Address
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Address Line | 4303 DUDLEY DR NE
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City | LACEY
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State | WA
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Zip | 98516-5658
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SEUNG JAE JOUNG
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Credential | DMD
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Telephone | 412-759-1270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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