Individual
BONGOK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3885 HOLDREGE ST., LINCOLN, NE 68583-0740
(402) 472-8900
Mailing address
POBOX 830740, LINCOLN, NE 68583-0740
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
6993
NE
Other
Enumeration date
11/03/2011
Last updated
11/03/2011
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