Individual
JUN SOO SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
855 W MADISON ST APT 506, CHICAGO, IL 60607-3137
(808) 426-3816
Mailing address
855 W MADISON ST APT 506, CHICAGO, IL 60607-3137
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031809
IL
1223P0700X
Prosthodontics
021.003144
IL
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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