Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 04295 | NH |
NPI | 1346504925 |
---|---|
Provider Name | Jun Yu |
First Address | Nashua, NH 03064-2355 |
Second Address | Nashua, NH 03064-2355 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2012 |
Last Update Date | 16/03/2021 |