| Family Dentistry Of Dr Jessica Shin, Pllc | |
|
365 Aviation Rd Queensbury NY 12804-2915 | |
| (518) 798-5696 | |
| (518) 745-6854 |
| Full Name | Family Dentistry Of Dr Jessica Shin, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 365 Aviation Rd, Queensbury, New York |
| Authorized Official Name and Position | Jungwon Shin (OWNER/DENTIST) |
| Authorized Official Contact | 5187985696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dentistry Of Dr Jessica Shin, Pllc 365 Aviation Rd Queensbury NY 12804-2915 Ph: (518) 798-5696 | Family Dentistry Of Dr Jessica Shin, Pllc 365 Aviation Rd Queensbury NY 12804-2915 Ph: (518) 798-5696 |
| NPI Number | 1346529484 |
|---|---|
| Provider Enumeration Date | 08/08/2011 |
| Last Update Date | 03/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346529484 | NPI | - | NPPES |
| 1922122498 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 49328 (New York) | Primary |
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