Provider Demographics
NPI:1316930555
Name:CHAI, SOOK KUEEN (DMD)
Entity type:Individual
Prefix:DR
First Name:SOOK
Middle Name:KUEEN
Last Name:CHAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 TRILOGY ST
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-5346
Mailing Address - Country:US
Mailing Address - Phone:760-798-0612
Mailing Address - Fax:
Practice Address - Street 1:1 ST DENTAL BATTALION
Practice Address - Street 2:BOX 555221
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-725-2766
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL122911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice