Provider Demographics
NPI:1235446055
Name:MIN, HOON (DMD)
Entity type:Individual
Prefix:
First Name:HOON
Middle Name:
Last Name:MIN
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 1:755 SCOTT CIRCLE
Mailing Address - Street 2:
Mailing Address - City:JOINT BASE PEARL HARBOR-HICKAM
Mailing Address - State:HI
Mailing Address - Zip Code:96853
Mailing Address - Country:US
Mailing Address - Phone:808-448-6371
Mailing Address - Fax:
Practice Address - Street 1:755 SCOTT CIRCLE
Practice Address - Street 2:
Practice Address - City:JOINT BASE PEARL HARBOR-HICKAM
Practice Address - State:HI
Practice Address - Zip Code:96853
Practice Address - Country:US
Practice Address - Phone:808-448-6371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026285001223P0700X
CT103361223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics