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General NPI Number Information
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NPI Number | 1720367006
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Entity Type | Individual
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Provider Name | HEE-CHUL CHUNG
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Gender | Male
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 08/04/2011
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Provider Practice Location Address
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Address Line | 1515 BLAIRS FERRY RD NE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52402-5804
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Country | US
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Telephone | 800-728-0768
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Fax |
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Provider Business Mailing Address
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Address Line | 20 LINCOLN AVE APT #1
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City | IOWA CITY
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State | IA
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Zip | 52246-2210
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Country | US
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Telephone | 319-331-9275
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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 | 08839
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License Number State | IA
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