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General NPI Number Information
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NPI Number | 1356720767
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Entity Type | Organization
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Legal Business Name | YOUNG JUN DDS MD INC
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 601 E YORBA LINDA BLVD 9
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City | PLACENTIA
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State | CA
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Zip | 92870-3006
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Country | US
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Telephone | 714-985-9690
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Fax | 714-985-1762
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Provider Business Mailing Address
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Address Line | 601 E YORBA LINDA BLVD 9
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City | PLACENTIA
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State | CA
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Zip | 92870-3006
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Country | US
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Telephone | 714-985-9690
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Fax | 714-985-1762
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | YOUNG JUN
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Credential | DDS
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Telephone | 714-985-9690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 55513
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License Number State | CA
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