Individual
JAE AN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
65 JEFFERSON AVE, ELIZABETH, NJ 07201-2474
(908) 469-9100
Mailing address
65 JEFFERSON AVE, ELIZABETH, NJ 07201-2474
(908) 469-9100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02811400
NJ
Other
Enumeration date
02/27/2019
Last updated
06/02/2025
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