Provider Demographics
NPI:1992910426
Name:PYO, HAN S. (DMD)
Entity type:Individual
Prefix:DR
First Name:HAN S.
Middle Name:
Last Name:PYO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12393 E CORNELL AVE
Mailing Address - Street 2:SUITE NUMBER 2
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3323
Mailing Address - Country:US
Mailing Address - Phone:303-755-1168
Mailing Address - Fax:
Practice Address - Street 1:12393 E CORNELL AVE
Practice Address - Street 2:SUITE NUMBER 2
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3323
Practice Address - Country:US
Practice Address - Phone:303-755-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice