Individual
DR. JUNG HYUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
598 W MAIN ST, NORWICH, CT 06360-5342
(917) 334-3544
Mailing address
598 W MAIN ST, UNIT 3, NORWICH, CT 06360-5342
(917) 334-3544
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
010808
CT
122300000X
Dentist
Primary
010809
CT
1223G0001X
General Practice Dentistry
14670
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235445354
—
CT
05
—
14375326357
—
CT
05
—
1629384987
—
CT
Enumeration date
08/26/2010
Last updated
10/19/2015
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