Provider Demographics
NPI:1366546491
Name:SUH, MIN S (DDS)
Entity type:Individual
Prefix:DR
First Name:MIN
Middle Name:S
Last Name:SUH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:SUH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:615 AVE D
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290
Mailing Address - Country:US
Mailing Address - Phone:360-568-2153
Mailing Address - Fax:360-568-5355
Practice Address - Street 1:615 AVE D
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290
Practice Address - Country:US
Practice Address - Phone:360-568-2153
Practice Address - Fax:360-568-5355
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE9062122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist