Provider Demographics
NPI:1447659610
Name:JONG UK YOOK
Entity type:Organization
Organization Name:JONG UK YOOK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONG
Authorized Official - Middle Name:UK
Authorized Official - Last Name:YOOK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-373-6537
Mailing Address - Street 1:3020 FLOYD AVE STE 609
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-9802
Mailing Address - Country:US
Mailing Address - Phone:209-551-1414
Mailing Address - Fax:
Practice Address - Street 1:3020 FLOYD AVE STE 609
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-9802
Practice Address - Country:US
Practice Address - Phone:209-551-1414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49434122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty