Jimmy Shak
Jimmy Shak is a Student in an Organized Health Care Education/Training Program in Old Bridge, New Jersey. Practices as a sole proprietor. Licensed in New Jersey.
- Licensed in
- NJ
- In the registry since
- 2018
- Specialties on file
- 2
Practice location Address checks out
Old Bridge, NJNo coordinates on file. Search this address in Google Maps
Specialties & licences
| Pediatric Dentistry (primary) | Taxonomy 1223P0221X · Licence 22DI02796200 (NJ) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1285132530 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | January 31, 2018 |
| Last updated in NPPES | May 17, 2021 |
| Certification date | April 27, 2021 |
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