| Organization Name: | DANIEL D. KIM, D.D.S., LLC |
| NPI Number: | 1114347192 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONGKYUN KIM (CLINICAL DIRECTOR) |
| Mailing Address: | 321 Broad Ave #5 Ridgefield |
| State: | NJ US |
| Postal Code: | 076572346 |
| Phone Number: | 2013132277 |
| Fax Number: | 2014966124 |
| NPI Enumeration Date: | 04/17/2014 |
| NPI Last Update Date: | 04/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0002X |
| License Number: | 22DI02255900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Emergency Care |
| Taxonomy Definition: | |