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General NPI Number Information
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NPI Number | 1417450073
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Entity Type | Individual
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Provider Name | MINJIN YOO DMD
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Gender | Female
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Dates
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Enumeration Date | 03/09/2018
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 7 S MAIN ST STE G
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City | MARLBORO
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State | NJ
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Zip | 07746-1578
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Country | US
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Telephone | 202-999-7886
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Fax |
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Provider Business Mailing Address
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Address Line | 405 KING GEORGE RD APT B-221
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-2812
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Country | US
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Telephone | 202-999-7886
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 12219
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22DI02885100
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License Number State | NJ
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