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Individual

DR. TAE-SOK KONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
7600 W COLLEGE DR, PALOS HEIGHTS, IL 60463-1001
(708) 361-1770
Mailing address
7600 W COLLEGE DR, PALOS HEIGHTS, IL 60463-1001
(708) 361-1770

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
021.002274
IL
1223G0001X
General Practice Dentistry
019.027600
IL
1223G0001X
General Practice Dentistry
2005015642
MO
1223G0001X
General Practice Dentistry
6602
NE

Other

Enumeration date
08/24/2008
Last updated
08/24/2008
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