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General NPI Number Information
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NPI Number | 1659498111
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Entity Type | Individual
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Provider Name | EUNKU CHUNG D.D.S., M.S.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 509 OLIVE WAY SUITE 1416
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City | SEATTLE
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State | WA
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Zip | 98101-1720
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Country | US
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Telephone | 206-623-3122
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Fax | 206-623-5266
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Provider Business Mailing Address
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Address Line | 509 OLIVE WAY SUITE 1416
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City | SEATTLE
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State | WA
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Zip | 98101-1720
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Country | US
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Telephone | 206-623-3122
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Fax | 206-623-5266
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | F-23123
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DE00010169
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License Number State | WA
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