Individual
HYO SUP SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
30 CENTRAL PARK S RM 11D, NEW YORK, NY 10019-1649
(646) 722-1177
Mailing address
30 CENTRAL PARK S RM 11D, NEW YORK, NY 10019-1649
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
062601
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2021
Last updated
03/30/2023
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