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General NPI Number Information
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NPI Number | 1932697554
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Entity Type | Individual
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Provider Name | SERENA SEKYUNG CHO DDS
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Gender | Female
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 22 S GREENE ST
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City | BALTIMORE
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State | MD
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Zip | 21201
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Country | US
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Telephone | 410-328-8667
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 QUARRY LAKE DR STE 190
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City | BALTIMORE
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State | MD
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Zip | 21209-3743
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 16814
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License Number State | MD
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