| NPI | 1255098620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONGJIN SHIN Dentist / Owner 857-540-2066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223G0001X Dentist, General Practice | |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2021-11-20 |
| Last Update Date | 2021-11-20 |