Provider Demographics
NPI:1619043247
Name:YOUNG, JOHN M JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:YOUNG
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:990 CEDAR BRIDGE AVE STE B15
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4158
Mailing Address - Country:US
Mailing Address - Phone:732-477-1808
Mailing Address - Fax:732-477-1490
Practice Address - Street 1:990 CEDAR BRIDGE AVE STE B15
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4158
Practice Address - Country:US
Practice Address - Phone:732-477-1808
Practice Address - Fax:732-477-1490
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJD10183301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics