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General NPI Number Information
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NPI Number | 1821248758
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Entity Type | Individual
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Provider Name | SEO YEON YU D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 153 DYCKMAN ST
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City | NEW YORK
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State | NY
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Zip | 10040-1003
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Country | US
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Telephone | 212-569-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 336B 7TH ST
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City | PALISADES PARK
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State | NJ
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Zip | 07650-2225
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Country | US
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Telephone | 917-519-3737
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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 | 053240-1
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License Number State | NY
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