Organization
BROADWAY DENTAL ARTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTEW MIN KUY KIM DDS (PRESIDENT)
(212) 410-6969
Entity
Organization
Contact information
Practice address
738 BROADWAY, BROOKLYN, NY 11206-4403
(212) 410-6969
(212) 410-6989
Mailing address
2071 2ND AVE, NEW YORK, NY 10029-4101
(212) 410-6969
(212) 410-6989
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
054305
NY
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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