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General NPI Number Information
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NPI Number | 1962823062
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Entity Type | Organization
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Legal Business Name | SMITH & TCHON, D.D.S., INC.
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 3661 TORRANCE BLVD SUITE 100
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City | TORRANCE
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State | CA
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Zip | 90503-4812
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Country | US
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Telephone | 310-792-7775
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Fax | 310-792-7773
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Provider Business Mailing Address
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Address Line | 3661 TORRANCE BLVD SUITE 100
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City | TORRANCE
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State | CA
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Zip | 90503-4812
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Country | US
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Telephone | 310-792-7775
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Fax | 310-792-7773
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMUEL SUNGHOON TCHON
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Credential | D.D.S., M.D.
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Telephone | 310-709-6201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 61830
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License Number State | CA
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