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General NPI Number Information
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NPI Number | 1184756934
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Entity Type | Individual
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Provider Name | YOUJIN NATALIE JEONG D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 160 LINCOLN RD
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City | LINCOLN
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State | MA
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Zip | 01773
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Country | US
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Telephone | 781-259-1600
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Fax | 781-259-1601
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Provider Business Mailing Address
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Address Line | 160 LINCOLN RD P.O. BOX 262
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City | LINCOLN
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State | MA
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Zip | 01773
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Country | US
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Telephone | 781-259-1600
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Fax | 781-259-1601
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 20074
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License Number State | MA
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