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Provider Information for 1619043247

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. JOHN M YOUNG JR. DDS

Gender: MALE

Individual NPI: 1619043247

Calendar   Last Updated:  2018-09-11
  Certification Date: 

Details

Name Value
NPI 1619043247
Enumeration Date 2006-11-27
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 990 CEDAR BRIDGE AVE STE B15
BRICK, NJ 08723-4158
United States

Phone: 732-477-1808 | Fax: 732-477-1490
View Map External Link
Primary Practice Address 990 CEDAR BRIDGE AVE STE B15
BRICK, NJ 08723-4158
United States

Phone: 732-477-1808 | Fax: 732-477-1490
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223X0400X - Dentist Orthodontics and Dentofacial Orthopedics NJ D1018330