MEDICARE: EUN LAUREN HUR DMD

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	22DI0252534300	NJ

General Provider Information

NPI Number	:	1235575176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUN LAUREN HUR DMD

Provider Business Mailing Address
First Line	:	412 SUMMIT AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-3101
Country	:	US
Telephone Number	:	201-499-1975
Fax Number	:	201-946-6804

Provider Business Practice Location Address
First Line	:	412 SUMMIT AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-3101
Country	:	US
Telephone Number	:	201-499-1975
Fax Number	:	201-946-6804

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

Provider Enumeration Date	:	05/20/2013
Last Update Date	:	05/20/2013

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