Individual
DR. VICKI CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1218 S CASHUA DR, FLORENCE, SC 29501-6319
(843) 667-6460
Mailing address
402 BURRIS RD, FLORENCE, SC 29501-5425
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3768
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9616
—
SC
Enumeration date
01/26/2007
Last updated
07/08/2007
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