Individual
JONG RYUL KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3223 N BROAD ST, PHILADELPHIA, PA 19140-5007
(215) 707-2900
Mailing address
3223 N BROAD ST, PHILADELPHIA, PA 19140-5007
(215) 707-2900
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
0401414600
VA
1223E0200X
Endodontics
Primary
DS041524
PA
Other
Enumeration date
10/20/2014
Last updated
12/19/2022
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