Organization
LINCOLN PARK DENTAL CARE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEONG JU KIM DDS. (GENERAL DENTIST)
(773) 404-0101
Entity
Organization
Contact information
Practice address
424 W FULLERTON PKWY, CHICAGO, IL 60614-2812
(773) 404-0101
(773) 404-1260
Mailing address
424 W FULLERTON PKWY, CHICAGO, IL 60614-2812
(773) 404-0101
(773) 404-1260
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025117
IL
Other
Enumeration date
05/06/2008
Last updated
05/06/2008
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