Ilcheon Joo D.D.S

NPI 1063530509 - Dentist - 122300000X

NPI Details
NPI 1063530509
Gender Male
Enumeration Date 03/26/2007
Last Updated 12/08/2009
Entity Type Individual
Active Over 9 years ago
Practice Location
46 MIFFLIN ST
PINE GROVE PA, 17963-1318, US
Phone (570) 345-3495
Fax (570) 345-3161
Business Location
6690 HAUSER RD
M101
MACUNGIE PA, 18062-8102, US
Phone
Fax
Toxanomy
Taxonomy Code 122300000X
License State Pennsylvania
License Number DS037775
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According to our database, Dr. Ilcheon Joo D.D.S NPI is 1063530509, taxonomy code is 122300000X and license number is DS037775, license state is located at Pennsylvania. Ilcheon Joo D.D.S physically located at 46 Mifflin St, Pine Grove PA, 17963-1318. NPI Number Ilcheon Joo D.D.S has the Individual type.

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1063530509 NPI number is provided on an as is basis without warranty of any kind. 1063530509 is maintained by the National Plan & Provider Enumeration System. The contents of Ilcheon Joo D.D.S are for informational purposes only.