Individual
DR. JAEYOUNG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4754 COMMERCIAL DR STE 2, NEW HARTFORD, NY 13413-6205
(646) 522-5339
Mailing address
4754 COMMERCIAL DR STE 2, NEW HARTFORD, NY 13413-6205
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
061319
NY
1223G0001X
General Practice Dentistry
22DI02786700
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/14/2019
Last updated
08/14/2023
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