MEDICARE: DR. JOON H. HONG 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	22DI02094700	NJ

General Provider Information

NPI Number	:	1750360582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOON H. HONG DDS

Provider Business Mailing Address
First Line	:	1509 PALISADE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5345
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1509 PALISADE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5345
Country	:	US
Telephone Number	:	201-461-2828
Fax Number	:	201-461-2881

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

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	07/08/2007

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