Provider Demographics
NPI:1992048318
Name:DAVID C SUH D D S INC
Entity type:Organization
Organization Name:DAVID C SUH D D S INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-326-9572
Mailing Address - Street 1:3655 LOMITA BLVD STE 217
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3958
Mailing Address - Country:US
Mailing Address - Phone:310-326-8572
Mailing Address - Fax:310-326-1991
Practice Address - Street 1:3655 LOMITA BLVD STE 217
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3958
Practice Address - Country:US
Practice Address - Phone:310-326-8572
Practice Address - Fax:310-326-1991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51197122300000X
261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial SurgeryGroup - Single Specialty