Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DS039671 | PA |
NPI | 1033404215 |
---|---|
Provider Name | Hyun S Choi |
First Address | Scranton, PA 18503-1221 |
Second Address | Scranton, PA 18503-1221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2011 |
Last Update Date | 13/04/2015 |