Individual
SUNG RAE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
570 PIERMONT RD, SUITE C1, CLOSTER, NJ 07624-3100
(201) 666-2828
(201) 750-2314
Mailing address
570 PIERMONT ROAD, SUITE C1, CLOSTER, NJ 07624
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
047461-1
NY
122300000X
Dentist
22DI01975100
NJ
1223P0700X
Prosthodontics
Primary
DI19751
NJ
Other
Enumeration date
01/06/2014
Last updated
01/06/2014
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