Individual
CHONG YON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
935 RIVERDALE ST, WEST SPRINGFIELD, MA 01089-4656
(315) 295-2589
Mailing address
P.O. BOX 20879, BARRIGADA, GUAM 96921
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12571
CT
Other
Enumeration date
03/25/2019
Last updated
07/15/2019
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