Organization
FAMILY DENTISTRY OF EPHRATA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOOSON E KIM DMD (OWNER)
(717) 738-0124
Entity
Organization
Contact information
Practice address
1065 SHARP AVE, EPHRATA, PA 17522-1135
(717) 738-0124
(717) 721-1043
Mailing address
1065 SHARP AVE, EPHRATA, PA 17522-1135
(717) 738-0124
(717) 721-1043
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023088408
INDIVIDUAL NPI
PA
Enumeration date
03/18/2020
Last updated
03/18/2020
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