MEDICARE: EUNA JOY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	56112	CA

General Provider Information

NPI Number	:	1043491913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUNA JOY DDS

Provider Business Mailing Address
First Line	:	513 RUSS ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-4450
Country	:	US
Telephone Number	:	707-443-3815
Fax Number	:	707-826-8638

Provider Business Practice Location Address
First Line	:	513 RUSS ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-4450
Country	:	US
Telephone Number	:	707-443-3815
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2007
Last Update Date	:	10/18/2021

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Directions to “ EUNA JOY DDS” Practice Location

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