Provider Demographics
NPI:1427246925
Name:SUNG, JUIN-BANG
Entity type:Individual
Prefix:MR
First Name:JUIN-BANG
Middle Name:
Last Name:SUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 N GARFIELD AVE
Mailing Address - Street 2:SUITE A&B
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1708
Mailing Address - Country:US
Mailing Address - Phone:626-288-1688
Mailing Address - Fax:626-872-0650
Practice Address - Street 1:328 N GARFIELD AVE
Practice Address - Street 2:SUITE A&B
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1708
Practice Address - Country:US
Practice Address - Phone:626-288-1688
Practice Address - Fax:626-872-0650
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32403122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist