Individual
JAI HYUN NAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
269 LIVINGSTON ST STE G, NORTHVALE, NJ 07647-1918
(201) 784-1930
Mailing address
2030 HUDSON ST APT 1236, FORT LEE, NJ 07024-7227
(617) 894-4289
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
060513-01
NY
122300000X
Dentist
Primary
22DI02822600
NJ
Other
Enumeration date
06/14/2017
Last updated
06/13/2021
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