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Individual

ISAAC DU QUOC CHUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
10463 PARK MEADOWS DR STE 206, LONE TREE, CO 80124-5318
(303) 662-9000
Mailing address
10463 PARK MEADOWS DR STE 206, LONE TREE, CO 80124-5318
(303) 662-9000

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN.00203039
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1720508518
CO
01
DEN.00203039
CO DENTAL LICENSE
CO
Enumeration date
06/22/2017
Last updated
01/21/2022
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