Individual
SAMUEL EUNGOOK KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
385 S MAPLE AVE STE 207, GLEN ROCK, NJ 07452-1545
(201) 380-2236
Mailing address
7 LINWOOD RD N, PORT WASHINGTON, NY 11050-1411
(516) 497-8068
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
14093
CT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI03027100
NJ
Other
Enumeration date
03/02/2020
Last updated
08/08/2024
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