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NPI Code Detail

MEDICARE: SEUNG HYUNG SON D.D.S.

MEDICARE: SEUNG HYUNG SON D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry28110TX
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1023300555
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEUNG HYUNG SON D.D.S.
Provider Business Mailing Address
First Line : 22102 GLEN ARDEN LN
Second Line :
City : KATY
State : TX
Zip : 77450-7616
Country : US
Telephone Number : 917-930-4810
Fax Number :
Provider Business Practice Location Address
First Line : 6295 BISSONNET ST
Second Line :
City : HOUSTON
State : TX
Zip : 77081-6809
Country : US
Telephone Number : 917-930-4810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2011
Last Update Date : 12/17/2014

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