Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 13286 | MD |
NPI | 1194863720 |
---|---|
Provider Name | Seung Paik |
First Address | Annapolis, MD 21401-7300 |
Second Address | Annapolis, MD 21401-7300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2007 |
Last Update Date | 08/07/2007 |