Individual
ANDY KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3905 61ST ST FL 2, WOODSIDE, NY 11377-3566
(718) 388-5566
Mailing address
207 E 30TH ST APT 1E, NEW YORK, NY 10016-8277
(201) 705-8454
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
064518
NY
Other
Enumeration date
05/26/2023
Last updated
09/03/2025
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