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Individual

EUI SIK SHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1900 N BROADWAY, BALTIMORE, MD 21213-1437
(443) 241-2516
Mailing address
11045 NASHVILLE CT, ELLICOTT CITY, MD 21042-2485
(312) 505-1629

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
8982
AZ
1223G0001X
General Practice Dentistry
Primary
0401417775
VA
1223G0001X
General Practice Dentistry
16102
MD
1223G0001X
General Practice Dentistry
30901
TX
1223G0001X
General Practice Dentistry
8982
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144651
MD
05
349710901
TX
05
927285
AZ
Enumeration date
07/14/2014
Last updated
07/07/2022
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