# SUNG RAE KIM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1679995955
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 047461-1 | NY | — |
| 122300000X | Dentist | 22DI01975100 | NJ | — |
| 1223P0700X | Prosthodontics | DI19751 | NJ | Yes |

## Other

- **Enumeration date:** 01/06/2014
- **Last updated:** 01/06/2014