MEDICARE: DR. SUNG HOON JUN DDS

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
1	1223G0001X	General Practice Dentistry	15012	MD

General Provider Information

NPI Number	:	1215298500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUNG HOON JUN DDS

Provider Business Mailing Address
First Line	:	14414 OLD MILL RD
Second Line	:	SUITE 101
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-3186
Country	:	US
Telephone Number	:	301-627-6646
Fax Number	:	301-627-4996

Provider Business Practice Location Address
First Line	:	14414 OLD MILL RD
Second Line	:	SUITE 101
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-3186
Country	:	US
Telephone Number	:	301-627-6646
Fax Number	:	301-627-4996

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2012
Last Update Date	:	10/30/2017

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