Provider Demographics
NPI:1407978208
Name:KUN, JASNA (DMD)
Entity Type:Individual
Prefix:
First Name:JASNA
Middle Name:
Last Name:KUN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BOSTON POST RD W
Mailing Address - Street 2:SUITE 409
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-4667
Mailing Address - Country:US
Mailing Address - Phone:508-485-6723
Mailing Address - Fax:508-229-8544
Practice Address - Street 1:201 BOSTON POST RD W
Practice Address - Street 2:SUITE 409
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-4667
Practice Address - Country:US
Practice Address - Phone:508-485-6723
Practice Address - Fax:508-229-8544
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA190871223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics