Organization
FORDHAM DENTAL CARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HYEONG CHAN KIM DDS (PRESIDENT)
(917) 962-9990
Entity
Organization
Contact information
Practice address
573 E FORDHAM RD, STORE FRONT, BRONX, NY 10458-5018
(917) 962-9990
(917) 962-9992
Mailing address
573 E FORDHAM RD, STORE FRONT, BRONX, NY 10458-5018
(917) 962-9990
(917) 962-9992
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
055881-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03463949
—
NY
Enumeration date
03/15/2013
Last updated
03/15/2013
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