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General NPI Number Information
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NPI Number | 1972202497
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Entity Type | Organization
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Legal Business Name | COZY DENTAL
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 233 E SHORE RD STE 110
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City | GREAT NECK
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State | NY
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Zip | 11023-2433
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Country | US
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Telephone | 516-304-5486
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Fax |
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Provider Business Mailing Address
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Address Line | 127 MUNSEY RD
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City | EMERSON
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State | NJ
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Zip | 07630-1513
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Country | US
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Telephone | 201-927-7144
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. EUNJUNG SHIM
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Credential | DMD, MSD
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Telephone | 201-927-7144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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