Individual
DR. JIN SUP SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
133 E 58TH ST STE 912, NEW YORK, NY 10022-1283
(646) 760-8028
Mailing address
4117 CRESCENT ST APT 4B, LONG ISLAND CITY, NY 11101-3862
(917) 971-3232
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
060492
NY
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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