Provider Demographics
NPI:1598443251
Name:JUN, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:JUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W FRANKLIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4700
Mailing Address - Country:US
Mailing Address - Phone:937-304-1357
Mailing Address - Fax:
Practice Address - Street 1:201 W FRANKLIN ST STE D
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4700
Practice Address - Country:US
Practice Address - Phone:937-304-1357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126900000XDental ProvidersDental Laboratory Technician