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Organization
BERGEN PROSTHODONTICS LLC
Active
Organization
BERGEN PROSTHODONTICS LLC
Active
Other names
MONTVALE PROSTHODONTICS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNG EUN KIM DMD, MMSC (CEO/DENTIST)
(201) 582-2264
Entity
Organization
Contact information
Practice address
102 CHESTNUT RIDGE RD STE 201, MONTVALE, NJ 07645-1856
(201) 582-2264
Mailing address
22 GARNET DR, WOODLAND PARK, NJ 07424-4215
(201) 988-5633
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
NULL
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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