Individual
DR. TRACY KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3905 61ST ST, WOODSIDE, NY 11377-3566
(917) 963-7230
Mailing address
3905 61ST ST, WOODSIDE, NY 11377-3566
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
059005
NY
Other
Enumeration date
06/24/2014
Last updated
03/17/2018
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