Provider Demographics
NPI:1528159878
Name:SUH, DANIEL Y (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:Y
Last Name:SUH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:YOUNGDAE
Other - Middle Name:
Other - Last Name:SUH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:725 RIVER RD
Mailing Address - Street 2:53
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1171
Mailing Address - Country:US
Mailing Address - Phone:201-943-4000
Mailing Address - Fax:201-943-9714
Practice Address - Street 1:725 RIVER RD STE 53
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1149
Practice Address - Country:US
Practice Address - Phone:201-943-4000
Practice Address - Fax:201-943-9714
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 204641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice