Individual
PETER HYUNGBAIK JIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
535 BROAD AVE FL 2, PALISADES PARK, NJ 07650-1607
(201) 592-0111
Mailing address
535 BROAD AVE FL 2, PALISADES PARK, NJ 07650-1607
(201) 592-0111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02586300
NJ
1223G0001X
General Practice Dentistry
056094
NY
Other
Enumeration date
03/31/2011
Last updated
10/07/2014
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