Organization
FAMILY DENTISTRY OF DR JESSICA SHIN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUNGWON SHIN DDS (OWNER/DENTIST)
(518) 798-5696
Entity
Organization
Contact information
Practice address
365 AVIATION RD, QUEENSBURY, NY 12804-2915
(518) 798-5696
(518) 745-6854
Mailing address
365 AVIATION RD, QUEENSBURY, NY 12804-2915
(518) 798-5696
(518) 745-6854
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
49328
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02408799
—
NY
Enumeration date
03/30/2016
Last updated
03/30/2016
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