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General NPI Number Information
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NPI Number | 1780072181
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Entity Type | Organization
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Legal Business Name | JINA K. YOO, DMD, MS, PC
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 1107 S FIFTH ST SUITE 100
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City | MEBANE
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State | NC
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Zip | 27302-9597
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Country | US
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Telephone | 919-332-2840
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 S FIFTH ST SUITE 100
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City | MEBANE
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State | NC
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Zip | 27302-9597
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Country | US
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Telephone | 919-568-0103
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Fax |
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Authorized Official
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Title or Position | CEO AND PEDIATRIC DENTIST
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Name | DR. JINA KANG YOO
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Credential | D.M.D, M.S.
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Telephone | 919-568-0103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 8634
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License Number State | NC
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