Provider Demographics
NPI:1659943876
Name:SON, JUN HUR (DDS)
Entity Type:Individual
Prefix:
First Name:JUN
Middle Name:HUR
Last Name:SON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 MUNICIPAL DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-2923
Mailing Address - Country:US
Mailing Address - Phone:610-432-1200
Mailing Address - Fax:
Practice Address - Street 1:3655 MUNICIPAL DR
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-2923
Practice Address - Country:US
Practice Address - Phone:610-432-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0432711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice