Provider Demographics
NPI:1073400354
Name:HUR, EUN A (DMD)
Entity type:Individual
Prefix:
First Name:EUN
Middle Name:A
Last Name:HUR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 MARKET ST APT 1216
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:GA
Mailing Address - Zip Code:30620-1896
Mailing Address - Country:US
Mailing Address - Phone:954-410-6878
Mailing Address - Fax:
Practice Address - Street 1:4799 ATLANTA HWY STE 500
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-7467
Practice Address - Country:US
Practice Address - Phone:404-720-6097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPENDING122300000X
FLDN30498122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist