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NPI Code Detail

MEDICARE: CHRISTOPHER JUNG

MEDICARE:   CHRISTOPHER  JUNG
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
11223G0001XGeneral Practice Dentistry36557TX

General Provider Information

NPI Number : 1356952998
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER JUNG
Provider Business Mailing Address
First Line : 3100 MCCANN RD APT 706
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-7854
Country : US
Telephone Number : 972-768-3968
Fax Number :
Provider Business Practice Location Address
First Line : 3080 N EASTMAN RD
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-5174
Country : US
Telephone Number : 8-690-3686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2020
Last Update Date : 08/16/2020

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Directions to “ CHRISTOPHER JUNG ” Practice Location

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