Provider Demographics
NPI:1790178689
Name:P&J DENTAL CARE PLLC
Entity Type:Organization
Organization Name:P&J DENTAL CARE PLLC
Other - Org Name:EVERSMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:WON JUN
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-633-1909
Mailing Address - Street 1:2625 OLD DENTON RD
Mailing Address - Street 2:SUITE 578
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5125
Mailing Address - Country:US
Mailing Address - Phone:347-633-1909
Mailing Address - Fax:
Practice Address - Street 1:2625 OLD DENTON RD
Practice Address - Street 2:SUITE 578
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5125
Practice Address - Country:US
Practice Address - Phone:347-633-1909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28626122300000X
TX28107122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty