Provider Demographics
NPI:1144048943
Name:FIRST CHOICE DENTURE SERVICE
Entity type:Organization
Organization Name:FIRST CHOICE DENTURE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTURIST
Authorized Official - Prefix:
Authorized Official - First Name:HYUN KOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOON
Authorized Official - Suffix:
Authorized Official - Credentials:LD
Authorized Official - Phone:253-999-3032
Mailing Address - Street 1:3330 W COURT ST STE M
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-3875
Mailing Address - Country:US
Mailing Address - Phone:509-547-8661
Mailing Address - Fax:
Practice Address - Street 1:3330 W COURT ST STE M
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-3875
Practice Address - Country:US
Practice Address - Phone:509-547-8661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122400000XDental ProvidersDenturistGroup - Single Specialty