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Individual
DR. JAY D KIM
Active
Individual
DR. JAY D KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
058413
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
P69669 LIMITEDPERMIT
NY
Other
Enumeration date
05/25/2009
Last updated
10/12/2020
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