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NPI 1043491913

NPI 1043491913 : EUNA JOY DDS : EUREKA, CA

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General NPI Number Information
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    NPI Number           |    1043491913
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    Entity Type          |    Individual 
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    Provider Name        |    EUNA JOY DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/20/2007
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    Last Update Date     |    10/18/2021
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Provider Practice Location Address
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    Address Line         |    513 RUSS ST 
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    City                 |    EUREKA
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    State                |    CA
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    Zip                  |    95501-4450
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    Country              |    US
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    Telephone            |    707-443-3815
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    513 RUSS ST 
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    City                 |    EUREKA
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    State                |    CA
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    Zip                  |    95501-4450
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    Country              |    US
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    Telephone            |    707-443-3815
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    Fax                  |    707-826-8638
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    56112
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    License Number State |    CA
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