Individual
DR. JICHEOL SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
460 SYLVAN AVE # 1F, ENGLEWOOD CLIFFS, NJ 07632-2919
(201) 461-0002
(201) 816-1144
Mailing address
108 LAKEVIEW DR, OLD TAPPAN, NJ 07675-7096
(201) 497-5207
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02357800
NJ
Other
Enumeration date
11/07/2007
Last updated
02/29/2008
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