Individual
KIBEOM SEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
105 MYRTLE ST, NEW BRITAIN, CT 06051-1859
(860) 801-8650
Mailing address
4234 TOWN BROOKE, MIDDLETOWN, CT 06457-6612
(716) 352-8080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12938
CT
1223G0001X
General Practice Dentistry
Primary
12938
CT
Other
Enumeration date
11/24/2020
Last updated
11/01/2024
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