Individual
DR. RICHARD HYUNGSANG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
1990 PREMIERE DR, MANKATO, MN 56001-5900
(507) 625-9330
(507) 625-1440
Mailing address
1990 PREMIERE DR, MANKATO, MN 56001-5900
(507) 625-9330
(507) 625-1440
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
100680
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D11363
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
355K4KI
BLUE CROSS
MN
Enumeration date
12/13/2006
Last updated
07/08/2007
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