Provider Demographics
NPI:1710078308
Name:SUN, JUNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUNE
Middle Name:
Last Name:SUN
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 1:1300 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-2532
Mailing Address - Country:US
Mailing Address - Phone:856-825-2246
Mailing Address - Fax:856-825-6888
Practice Address - Street 1:1300 N HIGH ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-2532
Practice Address - Country:US
Practice Address - Phone:856-825-2246
Practice Address - Fax:856-825-6888
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI019088001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice