Individual
BO YOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
432 E 149TH ST, BRONX, NY 10455-1343
(718) 618-7564
Mailing address
49 LAMBERT ST, ROSLYN HEIGHTS, NY 11577-2030
(631) 902-5941
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
059940
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2017
Last updated
11/01/2019
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