Individual
LEONARDO NICOLAS SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3700 MARKET ST STE 101, PHILADELPHIA, PA 19104-3173
(215) 387-0883
Mailing address
567 N 20TH ST APT 2, PHILADELPHIA, PA 19130-3228
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS044600
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Enumeration date
05/06/2024
Last updated
06/24/2024
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