Individual
JASON DONGHYUN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
542 NEW YORK AVE, LYNDHURST, NJ 07071-1532
(201) 623-3355
Mailing address
901 MOUNTAIN AVE # SC13, SPRINGFIELD, NJ 07081-3414
(973) 506-0159
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02806400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/28/2019
Last updated
08/27/2021
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