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Organization
KS DENTISTRY
Active
Organization
KS DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY YOO DDS (PRESIDENT)
(917) 524-5622
Entity
Organization
Contact information
Practice address
360 W 43RD ST APT S6A, NEW YORK, NY 10036-6486
(917) 524-5622
Mailing address
360 W 43RD ST APT S6A, NEW YORK, NY 10036-6486
(917) 524-5622
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
50-055536
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03427369
—
NY
Enumeration date
05/11/2017
Last updated
05/11/2017
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