Individual
KYUNG SANG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
TINGAY DENTAL CLINIC, 320 W HOSPITAL ROAD, FORT GORDON, GA 30905-0001
(067) 875-1027
Mailing address
TINGAY DENTAL CLINIC, 320 W HOSPITAL ROAD, FORT GORDON, GA 30905-3976
(703) 638-9410
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
20536
MA
1223P0700X
Prosthodontics
Primary
DN20536
MA
Other
Enumeration date
05/04/2006
Last updated
03/04/2023
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