Individual
YUNG KYUN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
UNIVERSITY OF CONNECTICUT HEALTH CTR, 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-0001
(860) 679-4070
Mailing address
6470 CLOVERDALE BLVD, OAKLAND GARDENS, NY 11364-2721
(917) 375-9593
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
053348-1
NY
1223P0300X
Periodontics
Primary
010754
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010754
DENTAL LICENSE
CT
01
—
053348-1
LICENSE
NY
Enumeration date
06/15/2007
Last updated
01/24/2013
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