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NPI 1689822371

NPI 1689822371 : MICHAEL SUNWOO D.D.S. : IRVINE, CA

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General NPI Number Information
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    NPI Number           |    1689822371
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL SUNWOO D.D.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/05/2008
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    Last Update Date     |    09/05/2008
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Provider Practice Location Address
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    Address Line         |    8 CLOVE BLOSSOM 
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    City                 |    IRVINE
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    State                |    CA
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    Zip                  |    92604-3232
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    Country              |    US
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    Telephone            |    949-857-9303
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    75TH MED CO (AS) UNIT #15190
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    City                 |    APO
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    State                |    AP
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    Zip                  |    96271
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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    |    
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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        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    7065176-9921
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    License Number State |    UT
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