Individual
DR. JOHN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
47 MAMARONECK AVE, WHITE PLAINS, NY 10601-4215
(914) 997-0566
Mailing address
4639 216TH ST, BAYSIDE, NY 11361-3452
(718) 225-0256
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
048198
NY
Other
Enumeration date
12/10/2009
Last updated
03/12/2010
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