Provider Demographics
NPI:1922103506
Name:HUANG, JUNG-SAN CAROLYN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUNG-SAN
Middle Name:CAROLYN
Last Name:HUANG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:46 CHARLES RD
Mailing Address - Street 2:
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924-1921
Mailing Address - Country:US
Mailing Address - Phone:908-630-0639
Mailing Address - Fax:
Practice Address - Street 1:1 RONALD DR
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-1420
Practice Address - Country:US
Practice Address - Phone:973-884-8686
Practice Address - Fax:973-884-1666
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI170331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice