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General NPI Number Information
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NPI Number | 1831257435
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Entity Type | Organization
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Legal Business Name | SEUNG S JUNG DDS MDS PA
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 8927 JM KEYNES DR #330
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City | CHARLOTTE
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State | NC
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Zip | 28262
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Country | US
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Telephone | 704-594-9808
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Fax | 704-594-9807
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Provider Business Mailing Address
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Address Line | 8927 JM KEYNES DR #330
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City | CHARLOTTE
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State | NC
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Zip | 28262
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Country | US
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Telephone | 704-594-9808
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Fax | 704-594-9807
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SEUNG SOO JUNG
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Credential | DDS MDS
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Telephone | 704-594-9808
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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 |
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License Number State |
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