Individual
HAYEON KOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1315 ANDERSON AVE STE A, FORT LEE, NJ 07024-1732
(013) 059-8082
Mailing address
1315 ANDERSON AVE STE A, FORT LEE, NJ 07024-1732
(201) 305-9808
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI027668800
NJ
Other
Enumeration date
04/06/2018
Last updated
01/14/2020
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