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General NPI Number Information
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NPI Number | 1922394550
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Entity Type | Organization
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Legal Business Name | JOHN JK CHOI, DMD PC
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 4 PROGRESS ST SIOTE A-2
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City | EDISON
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State | NJ
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Zip | 08820-1199
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Country | US
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Telephone | 908-754-9322
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Fax | 908-755-9364
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Provider Business Mailing Address
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Address Line | 4 PROGRESS ST SUITE A-2
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City | EDISON
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State | NJ
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Zip | 08820-1199
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Country | US
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Telephone | 908-754-9322
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Fax | 908-755-9364
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Authorized Official
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Title or Position | PRIMARY SHAREHOLDER
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Name | DR. JOHN J CHOI
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Credential | DMD
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Telephone | 908-754-9322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DI018664
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License Number State | NJ
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