Individual
MR. JONATHAN JOONHO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
260 E 188TH ST, BRONX, NY 10458-5302
(718) 960-9000
Mailing address
2428A CALIFORNIA ST, SAN FRANCISCO, CA 94115-2689
(209) 662-0965
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
058167
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/26/2014
Last updated
04/19/2017
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